A new company's proposal to build an ambulatory surgical center in Kenai, AK has caused uncertainty in the local medical community and Central Peninsula Hospital officials to ready their defenses. Kahtnu Ventures, LLC recently filed an application for a certificate of need with the Alaska Department of Health and Social Services for an 8,365 square foot "ambulatory surgical center." According to the application, the company hopes to build the estimated $8 million facility by spring of 2013 and service the Kenai and Northern Kenai Peninsula area. Ryan Smith, Central Peninsula Hospital CEO, said the origins of the company are somewhat mysterious. Smith said if the center is approved after the required lengthy public process, it could spell financial troubles for CPH.
Rising from a 60-acre field of old cypress swamp and cattle pasture near the Orlando airport, the 7-story Nemours Children's Hospital will be a monument to "best-in-class" care, its leaders boast. That may be the case. But at a cost of about $400 million, the equivalent of $4.2-million for each of its 95 beds, Nemours will also rank among the more expensive children's hospitals ever built when it is completed next year. Some people believe construction never should have begun. Florida health planners twice rejected Nemours' applications for a new hospital, noting that Orlando already had two children's hospitals; most cities have only one. A third hospital could duplicate existing services, driving up costs for insurers, employers and policyholders.
Obama administration lawyers face a decision by Monday that carries a high political risk and will probably determine whether the Supreme Court decides on the constitutionality of the healthcare law before next year's presidential election. The Justice Department could ask the full U.S. 11th Circuit Court of Appeals in Atlanta to reconsider a 2-1 decision in August that declared the law's mandate that all Americans must have health insurance unconstitutional. But seeking the full court review could take weeks, or even months, and probably push back a Supreme Court ruling until 2013. Or government lawyers could opt to skip the full review in the lower court and appeal directly to the Supreme Court this fall.
Donald Berwick, MD, doesn't know what he'll be doing after Dec. 31. The Harvard pediatrician who runs the federal Centers for Medicare & Medicaid Services needs Senate approval by the end of the year, or he's out of a job. No confirmation hearings have been scheduled. Berwick, who met with editors and reporters at The Boston Globe Friday morning, said he doesn't think often about his future after Medicare, both because he's prohibited under ethics rules from interviewing for jobs and because his current work is so intense. "This is the best job I've ever had and the best job in American healthcare," he said. During his visit to the Globe, Berwick repeatedly hit on the theme of improving care and saving money by "making care coordinated, seamless, and scientifically-based." He spoke of curing the American health care system of its "addiction to volume" rather than to quality.
Vanderbilt University Medical Center has partnered with three other not-for-profit hospitals across Middle Tennessee in a still-evolving project the hospitals say will boost medical services in suburban markets. Affiliation agreements with Williamson Medical Center in Franklin, Maury Regional Medical Center in Columbia, TN, and NorthCrest Medical Center in Springfield could lead to a joint approach in areas such as cancer treatment, cardiovascular services, high-risk pregnancies, diagnostic imaging and perhaps medical office development. Specific services could vary by location and are still being discussed, officials said. "It will let us be partners instead of competitors," said Dennis E. Miller, CEO of the 185-bed Williamson Medical Center.
Taxpayers spend less on a Medicaid prescription for the poor and disabled than they do on the same Medicare prescription for the elderly. So why not save money by having the government pay the same lower Medicaid price for drugs for both programs? That idea was the biggest spending cut proposed in President Barack Obama's deficit-reduction plan. But drug makers such as Eli Lilly and Co. argue that the cut would be a "pretty big body blow," potentially causing job losses and hurting the development of new drugs. Now, when the government buys Lilly's Zyprexa for a Medicare patient, for example, the cost is negotiated between the company and the private insurance provider of the Medicare drug benefit. When the government buys the same anti-psychotic medication for a Medicaid patient, Lilly has to give the government a set rebate.