CHE Trinity Health, the parent of Holy Cross Health in Silver Spring, named former Obama administration official Dr. Richard "Rick" Gilfillan as its new CEO Tuesday. Gilfillan is probably best known in Washington for being the first director of the Center for Medicare and Medicaid Innovation, a creation of the 2010 Affordable Care Act that funded and encouraged unconventional health payment reforms. Gilfillan also served as CEO of Geisinger Health Plan in Pennsylvania and was a senior executive for Bethesda-based Coventry Health Care. His medical degree is from Georgetown University.
A multi-billion dollar deal helped fuel third-quarter earnings growth for Aetna Inc., but the performance missed expectations, and shares slid Tuesday after it became the latest big health insurer to warn about challenges that lie ahead. Chairman and CEO Mark Bertolini told analysts that the Hartford, Conn., insurer is committed to growing operating earnings next year, and it expects the floor for its performance to be around where it finishes this year. But Aetna also expects to pay about $600 million toward a health insurance fee required as part of the health care overhaul, and it faces a Medicare Advantage funding cut also mandated by the law, which aims to fund coverage for millions of uninsured people over the next few years.
On its website, in its annual report and in some tax filings, UPMC purports to have employees -- sometimes tens of thousands of them, the city of Pittsburgh's attorneys said in a court filing. The amended complaint, filed Monday, comes in response to arguments made by a UPMC attorney last week that the medical conglomerate employs no one and therefore is not subject to payroll preparation taxes. The city sued UPMC on March 20 to strip it of its purely public charity status, which affords many of its subsidiaries and properties exemptions from taxes, including property and payroll taxes.
As states open insurance marketplaces amid uncertainty about whether they're a solution for health care, Vermont is eyeing a bigger goal, one that more fully embraces a government-funded model. Two years ago, the state passed a law to launch the nation's first universal health care system. Highlights of the plan: Beginning in 2017, the state will offer a set package of coverage benefits to every Vermont resident under the program, called Green Mountain Care. - A five-member board created under the law has already launched four pilot projects designed to bring down health care costs.
The American College of Cardiology is changing its guidelines for when implanting coronary stents is appropriate -- by banishing the term "inappropriate." Next year, the main U.S. heart-doctor group will remove the word it has used since 2009 to describe cases where people don't need the metal-mesh tubes in their blood vessels. The label has become a liability in treatment disputes with insurers and regulators, said Robert Hendel, who led the effort that updated the wording. "The term 'inappropriate' caused such a visceral response," said Hendel, a cardiologist at the University of Miami. "A lot of regulators and payers were saying, 'If it's inappropriate, why should we pay for it, and why should it be done at all?'"
When the floodwaters rose around New Orleans hospitals after Hurricane Katrina in 2005, doctors wondered whom to rescue first. Sick babies? Critically ill adults? The elderly? More than seven years later, as Hurricane Sandy hit New York City, Bellevue Hospital's basement filled with millions of gallons of floodwater from the East River. The physician heading the intensive care unit was told that most backup power was likely to fail. She would have six power outlets. Which of her 50 patients should get one?