It was decades before George W. Bush entered the White House—before he was born, actually—but humorist Will Rogers could have been speaking of the future 43rd president when he reputedly said that the motto of the Republican Party was "Boys, my back is turned."
I was reminded of that with the news last week that the U.S. Justice Department had intervened in a 4-year-old whistleblower suit filed in New Mexico against Franklin, TN-based Community Health Systems Inc.
What's interesting is not so much the content of the suit, but the fact that the Department of Justice has climbed aboard, something that many observers say didn't happen very much in the eight years that Bush occupied the White House.
"The Justice Department has a backlog of some 500-600 whistleblower and false claims cases in the healthcare industry that have not been taken up by the Bush administration," says Bruce Cranner, a board member of the Defense Research Institute, and a partner in the New Orleans firm of Frilot, LLC. "What does a 500 case backlog tell you about the Bush administration's attitude about pursuing these cases?"
"Now we see the Justice Department jumping in to a significant whistleblower case. That has a lot of ramifications in terms of what the new Obama administration and the new Justice Department will be looking for going forward," Cranner says.
According to the Justice Department, the suit alleges that CHS and three of its hospitals in New Mexico knowingly presented false claims for federal matching Medicaid funds, a violation of the False Claims Act.
A Justice Department media release did not detail how much money was at stake, but NashvillePost.com reports that a former employee in CHS' revenue management department—whistleblower Robert C. Baker—claims that $47.5 million was improperly collected from Medicaid in the form of disproportionate share payments.
According to DoJ, Baker's complaint alleges that beginning in the summer of 2000, CHS and its three New Mexico hospitals improperly obtained federal funds through the New Mexico Sole Community Provider Fund and Sole Community Hospital Supplemental Payments Medicaid programs. Baker alleges that CHS and its hospitals gave money to New Mexico counties which would be used by those counties and the state to claim and obtain triple that amount in federal funding that was then paid to the hospitals under the SCPF and SCHSP programs.
Included in the suit were three CHS hospitals: Eastern New Mexico Medical Center in Roswell, Mimbres Memorial Hospital in Deming, and Alta Vista Regional Hospital in Las Vegas.
CHS issued a statement denying any wrongdoing and says it "views this issue as a funding dispute between government agencies." While pledging that it has cooperated with the government, CHS also says it is "disappointed" by the government's decision to join the suit and will "vigorously defend itself."
Cranner says the CHS case may set a precedent in how Obama's DoJ pursues whistleblower cases. "If I were called by a healthcare entity who is being sued in a whistleblower case I would look very carefully at the factual and legal elements of this claim before I made a decision about how to defend," he says. "Its characteristics will tell us something about what the Justice Department will be doing and that they will be acting to collect in cases that it thinks are strong, and clearly it thinks this case is strong, or it wouldn't be there."
Let me be clear. I have no idea who is right or wrong in this suit, or whether any of the charges leveled against CHS are justified. They deserve the chance to make their case. But, whether intentionally or not, by jumping on this lawsuit less than two months after the president took office, the Obama Justice Department is sending a message to the healthcare sector that there is a new sheriff in town.
John Commins is the human resources and community and rural hospitals editor withHealthLeaders Media. He can be reached atjcommins@healthleadersmedia.com.
Note: You can sign up to receive HealthLeaders Media Community and Rural Hospital Weekly, a free weekly e-newsletter that provides news and information tailored to the specific needs of community hospitals.
In this economy, healthcare marketers are watching their budgets more closely than ever. Hospitals endure rising costs, pressure to increase access, and let's face it, they'd rather spend money on the latest CT scanner than media or creative talent. In response, marketers are finding that they can achieve great creative work and get more for their money by creating their own virtual agency.
Create your own agency
The virtual agency model differs from hiring freelancers or using a traditional ad agency in several ways. First, unlike an agency, you choose each team member. In addition, unlike freelancers, there's an ongoing, high level of collaboration. Resources may be freelancers, owners of small shops or even agency talent. Best of all, you pay a fraction of what a full-service agency would charge—and can still get great work.
Having worked at a healthcare ad agency and well aware of high agency fees, Mary Zokan turned to former colleagues for creative work when she became Director of Marketing at Rush-Copley Medical Center in Aurora, IL. With a small internal staff, she also added a freelance copywriter, designer, and media buyer for marketing campaigns and collateral projects. Later, she added two more former colleagues for TV, videos, and Web work.
Like Zokan, Marty Beerman, vice president of marketing and community relations at Children's Hospital in Omaha, NE, has an internal staff to handle the everyday marketing functions, but relies on an outside team for branding programs, advertising campaigns, and other projects.
Hungry to shift the strategic message, Beerman shopped for an ad agency, but decided that his freelance copywriter, paired with a design group he'd worked with in the past, and several other pros, could best accomplish his goals. Together, they determine strategy and then the creative team collaborates just as an agency's team does. They even hold weekly meetings.
Curb costs, not quality
One of the biggest benefits to creating your virtual agency is cost savings. No retainer fees. No markups. There is no overhead. No fancy building. No layers of account people logging hours. In fact, Tom Comes, director of marketing and public relations at Borgess Health in Kalamazoo, MI, estimates he spends about 50%–60% less than he would for an agency—and the hospital has won their share of awards. Plus, the virtual agency makes it easier for marketers to ensure brand consistency.
Like some hospital marketing directors, Comes had agency experience when he landed his current position, so he knew the process. He created his virtual agency when a marketing survey showed he needed to reestablish the hospital's brand. Frustrated by the prospect of reeducating an agency to the hospital's tone and processes he began working with an outside strategist, a media planner, two art directors, a producer for TV and radio, and four writers.
"I've worked with multiple, full-service agencies," Beerman says, "but the virtual agency model enables me to cherry-pick the best talent for a fraction of the cost." In fact, Beerman estimates he's saving more than 50% for the same quality work that an agency would deliver.
"The creative talent and strategic skills I have with my virtual agency is on par with any agency specializing in healthcare on a national level," says Zokan. "My key players have years of experience working for a national healthcare agency and I constantly rely on their professionalism, creative talent and strategic insight. Our work has consistently yielded top awards at state and national competitions."
These marketers also say the lack of layers inspires ownership of the work—among both internal and external staff. "Everyone here feels it's our work, so recognition is team-building," says Beerman.
Ultimately, the virtual agency model gives the marketing director more control over the brand, which produces better results. Plus, easy access to team members and quick turnarounds don't hurt either.
So what's the catch?
The only drawback Beerman sees is a little extra coordination. But for a person who enjoys participating in the creative process, he's not complaining. Likewise, marketers need to understand the process that goes on behind the agency's doors to know which skill sets they need. If they don't, they can recruit someone who does.
Even those who manage a large scope of activities appreciate the virtual agency model. In her position, Zokan manages marketing, advertising, public relations, community relations, and Web functions for a hospital, a medically-based fitness center, a group of multi-specialty physician practices, and a healthcare center in a neighboring community—all with her virtual agency.
"Team members need to understand and embrace their roles," says Zokan. "They know their limitations and they're the first to admit they're lacking a particular skill set. Then we find the right person. This is a loose, but fun and vastly different approach."
So when is it a good idea to use an ad agency? An agency might be helpful if you need a fresh direction or a project requires substantial hours. However, your virtual agency can be as full-service as you can build it.
Expect results
Expect the level of ownership and brand consistency to pay off in results. Since Zokan took her position six years ago, she has exceeded every marketing goal.
Beerman has similar results. In the year and a half since Beerman arrived at Children's, calls to the physician referral line jumped from 10 to 140 per month. Web visits increased 20% in the past year. Plus, Children's scores well on preference and awareness in its market—all without an increase in the media budget. Likewise, Comes reports that his virtual agency has helped increase ER volumes by 30% in less than three years.
"We all have had a tremendous stake in the results, so we feel a greater sense of responsibility—and accomplishment," says Zokan. "The virtual agency really puts me and my team on the line, but from a satisfaction and ownership standpoint, I wouldn't have it any other way."
How to Create Virtual Agency
It's easier than you think. First, identify the skill sets you need. Recruit former colleagues, your staff's contacts, and word-and-mouth recommendations. You want experienced professionals who may have previously worked for an agency or experienced freelancers. Choose people you like and respect. After all, this should be fun, right? Bring them all together, check the egos at the door, trade contact info, set your plan, and go.
Emily Thornton Calvo is a creative director/copywriter on Rush-Copley Medical Center's virtual agency team, which also includes Petrolis Design, Kinney/Kusek Marketing Communications and One57 Media.For information on how you can contribute to HealthLeaders Media online, please read our Editorial Guidelines.
Three powerful House committee chairmen have agreed to work together on legislation to overhaul the healthcare system, starting with the view that most employers should help finance coverage and that the government should offer a public health insurance plan as an alternative to private insurance. The three chairmen, George Miller and Henry A. Waxman of California and Charles B. Rangel of New York, all Democrats, have a combined total of more than 100 years of service in the House. The unified approach contrasts with the competition and rivalry among committee chairmen that helped sink President Bill Clinton's plan for universal health insurance.
More than 80 managers at Chicago-based Resurrection Health Care were let go as part of cost-cutting moves. Resurrection, which operates eight hospitals in Chicago and adjacent suburbs, said management, ambulatory services, and system support positions would be eliminated. Of those "81 employees have been laid off and an additional 44 vacant positions will not be filled," the Chicago health care system said in a statement.
A new Oakland, CA-based union—the product of a fight between the elected leaders of healthcare workers in Northern California and their superiors in Washington—has announced that it gained its first members. North American Healthcare agreed to recognize the National Union of Healthcare Workers as the representative of more than 350 nursing home workers at four of the company's facilities in Northern California, the union said. But United Healthcare Workers West and its parent union, the Service Employees International Union, which had until now represented those workers, are not giving them up without a fight.
Health policy experts say guaranteeing coverage for all Americans may cost about $1.5 trillion over the next decade, more than double the $634 billion "down payment" President Barack Obama set aside for health reform in his budget. The potential for runaway costs is raising concerns among Republicans and some Democrats as Congress prepares to draft next year's budget.
A Miami Beach woman left bedridden and in excruciating pain following spinal surgery in 2003 at Mount Sinai Medical Center was awarded $38 million by a Miami-Dade Circuit Court jury. The jury found that neurosurgeon Mario Nanes, Mount Sinai, and the hospital's pharmacy management firm caused Amanda Slavin's debilitating injuries. Mount Sinai settled before the case went to trial, so it's not on the hook to pay any part of the award. The hospital's pharmacy management firm at the time, McKesson Medication Management, vowed to appeal the decision. Nanes has been sued nine times by patients previously.
Challenges facing the University of Iowa Hospitals in the next five years will be recruiting enough healthcare workers, working more efficiently, and reaching out to smaller communities in Iowa, according to a group of Iowa healthcare leaders who gathered at the U of I to brainstorm ideas for the hospital's five-year strategic plan. The Iowa Board of Regents, which governs the U of I Hospitals, will consider these ideas and others to create a strategic plan.
St. Petersburg, FL-based All Children's Hospital plans to replace $60 million in auction rate securities issued in 2007 with fixed-rated tax-exempt bonds. The move will stabilize the hospital's capital costs, said Arnie Stenberg, executive vice president for administration at All Children's.
More physicians are embracing technological advances, such as electronic medical records, but most still consider them clunky and unresponsive to their needs, according to a recent survey by the American College of Physician Executives. Some doctors embrace the new measures, but a much larger number viewed healthcare technology as frustrating and difficult to use.
