The Wisconsin Physicians Service Insurance Corp., one of the largest health benefits providers in the state, inadvertently made overpayments to hospitals totaling $4.7 million from 2004 through 2006, according to a federal audit.
A U.S. Department of Health and Human Services inspector general's report found that 478 of the 520 Medicare payments from the Madison, WI, company were overpayments.
The payments were identified as so-called "high-dollar" amounts, at least $200,000 each.
The audit found that the payments were made after unnamed hospitals inaccurately reported information to the service provider contrary to federal guidance.
The inaccuracies included:
The number of billing units for blood clotting factor
Incorrect diagnosis and procedure codes
Excessive charges that resulted in inappropriate payments
According to federal officials, the "hospitals attributed most of the incorrect claims to data entry error and insufficient documentation."
The Wisconsin Physicians Service made the incorrect payments because neither the Fiscal Intermediary Standard System nor the Common Working File had sufficient edits in place to detect and prevent the overpayments, the audit report said.
WPS officials declined to discuss the audit. However, Mark DeFoil, director of contract coordination for Wisconsin Physicians Service, wrote in a letter to the inspector general: "WPS is in the process of adjusting the claims identified in this review" and "intends to recoup the associated overpayments as soon as possible."
"We will be utilizing the results of this audit, where applicable, in future educational activities," DeFoil added.
The inspector general office routinely reviews and determines overpayment issues on "dozens and dozens of cases with varied amounts of money," says Don White, a spokesman for the inspector general's office.
While there are "many audits [nationwide] where overpayments are found," White said the Wisconsin amount was "obviously a lot," referring to the $4.7 million.
The inspector general's office recommended Wisconsin Physicians Service should recover the overpayments. In addition, it should use the audit findings to review "provider education articles related to data entry procedures and proper documentation."
The Wisconsin company should also "consider implementing controls to identify and review all payments greater than $200,000 for inpatient services," according to the audit.
An overwhelming majority of small business owners say they do not offer health insurance to their employees, and most believe they will be hurt financially by healthcare reform, according to a survey released today by Discover Small Business Watch.
Still, the small business owners expressed higher economic hopes in January, largely because of increased expectations that conditions for their own businesses would improve in the next six months. The Discover Small Business Watch is a monthly survey of 750 small business owners, each with less than five employees.
"Healthcare continues to be a concern for most small business owners as they try to balance cost with other business obligations," says Ryan Scully, director of Discover's business credit card. "In terms of relief from the pending health insurance reform legislation, they aren't holding their collective breath for anything to change soon."
While a majority of small business owners rated the economy as "poor," and many believed their own business conditions will worsen, more small business owners are planning to increase business development spending over the next six months, according to the survey.
"January showed us the first month-to-month increase since August in the number of small business owners who plan to increase spending on business development," Scully said. The survey revealed that 24% would spend more on advertising, inventories, and capital expenditures—an increase of 18 % from December.
"Self-investment is a healthy sign in the small business economy," he says.
Among the findings in the January survey of small business owners:
81 % of small business owners say they do not offer health insurance to their employees—a decrease from 85 % in January 2009. That still represents an increase above the 77% in January 2008 and 74% in January 2007. Among others that offer health insurance, 29% considered discontinuing it because of cost. In addition, 21 % of owners are uninsured; down from 25% in January 2009. Of those who are insured, 34% of owners receive their coverage from another family member's plan.
58% say health reform will result in a worse health insurance situation. 23% believe their situation will improve, while 15% see "no impact" and 4% aren't sure.
58% rate the economy as poor, while 8% rate the economy as good or excellent—up from 4% in December.
31% believe the economy is getting better, which is up from 25% last month.
49% believe their own business conditions will get worse; 29% believe their own business conditions will improve over the next six months, which is an improvement from 22% in December and 19% in November 2009. On the other hand, 23% expect things to stay the same, while 4 % aren't sure.
46% believe the economy is getting worse—down from 49 % in December; another 18% "see the economy staying the same; 4% aren't sure.
51% of small business owners experienced cash flow issues in the past 90 days, which was unchanged from December; 46% have not experienced cash flow issues; 3% aren't sure.
Doctor-patient interaction is the key to a new telemedicine pilot program with community centers in California.
Under the California Telemedicine Pilot Project, more than 15 sites will be equipped to deliver telemedicine primary and specialty services using the networking system known as Cisco HealthPresence.
The "care-at-a-distance" plan will allow patients to visit a center with high-definition cameras and electronic scopes linked to physicians who may be a long distance away. While a physician assistant stands next to the patient and uses the necessary medical instruments, the physician can see or hear what's necessary in the examination, such as a patient's heartbeat. In turn, patients will be able to see and listen the same way as clinicians.
Indeed, potentially multiple members of a care team, including a primary care provider, specialist, case manager, and family members can meet in "real time"—at a distance.
"We're always looking for ways to reach the Medicare and Medi-Cal populations. A lot of patients, such as the disabled and blind population have mobility issues," says Rafael Amaro, MD, a medical director at Molina Health Care Inc.
Molina Health Care Inc. is a multi-state managed care organization that arranges for the delivery of healthcare services for Medicaid and Medicare beneficiaries and other government sponsored programs for low-income families and individuals. Molina Healthcare's licensed health plan subsidiaries serve about 1.4 million members.
Besides Molina Healthcare, other centers taking part include Mountain Health & Community Service and LaMaestra Community Health Centers, both in San Diego; and the University of California-Davis. The programs are expected to be operating within the next six months. Amaro says he is unsure how many patients may be served in the telemedicine pilot project.
The networking equipment company, Cisco Systems Inc., is contributing $10 million in products and services to support the project.
Telemedicine is considered a fast growing area for healthcare delivery options. In fact, Congress has earmarked billions of dollars for broadband infrastructure that can support telemedicine, according to Cisco officials.
Although the Cisco system, known as HealthPresence, has been in clinical settings for two years, company officials say the new pilot demonstrates the scale in which telemedicine can work, as well as new dimensions to the program.
Cisco officials said the state-of-the-art medical diagnostic equipment will provide healthcare professionals with excellent evaluation capabilities that is more "participatory and immersive" than in-person visits or telemedicine programs of the past.
"The technology has been around for a while, but this product is very high definition and capable with different instruments measuring the patient's needs," says Amaro. "We have stethoscopes you put on a chest and listen. You can use an otoscope and check the ears. You can look inside a throat."
In a statement, Gov. Arnold Schwarzenegger said: "We have been laying the groundwork for years with our Broadband Task Force and Telehealth Network and we are beginning to see fantastic results, including greater access to quality medical care throughout the state."
"What Cisco is doing here with the latest in high-tech approaches and communication is the future of medicine," Schwarzenegger said.
The Association of American Medical Colleges has estimated that the country is facing a potential shortage of 159,000 primary care physicians by 2025 because of population growth, aging, and other factors, according to Cisco. Telemedicine technologies are expected to help scarce healthcare professionals reach the widest possible population in the most efficient manner, according to Cisco.
"Healthcare is in the midst of a major market transition—and technology can make a tremendous impact," says John Chambers, chairman and chief executive officer of Cisco.
When the U.S. Food and Drug Administration evaluates new drug products for possible approval, the review process includes a risk-safety analysis known as Risk Evaluation and Mitigation Strategies (REMS).
Kaiser Permanente, the nation's largest publicly integrated healthcare delivery system, says the FDA has improperly excluded health insurers and others out of the REMS process, which was designed to improve drug safety.
The REMS process has had a "substantial" impact on the healthcare delivery system, notably contributing to higher costs, Kaiser Permanente says. The company did not detail those costs.
The Oakland, CA-based-Kaiser Permanente made its argument in a citizen petition filed with the FDA, saying it wants the federal agency to revise its "standards, procedures and guidelines" in developing and implementing REMS to comply fully with the law governing the policy.
In its petition, Kaiser Permanente was sharply critical of the FDA, saying the agency's REMS actions are "unduly burdensome" and "providers and patients continue to have little or no input into the development of these programs, which are intended to enhance safety for certain hazardous drugs."
A citizen petition filing with the FDA is not unusual. Members of the public are allowed to file the petitions, in part, to prompt the FDA to take certain action. They can be accepted or rejected. FDA officials declined to comment on the Kaiser Permanente petition.
Kaiser Permanente urged the FDA to form an advisory committee to deal with the issue. Among other things, it also asked that drug companies "not use requirements in REMS programs to give preferential treatment to certain health care providers."
The Kaiser Permanente petition was signed by Benjamin Chu, MD, MH, MACP, regional president of the Southern California Kaiser Foundation Health Plan Inc., Kaiser Foundation Hospitals; Sharon Levine, MD, associate executive director of the Permanente Medical Group; and Jed Weissberg, senior vice president, Quality and Care Delivery Excellence, Kaiser Foundation.
Neither FDA nor Kaiser Permanente officials would discuss the citizen's petition. But REMS has been a controversial tool used by the FDA, triggering some complaints over the years, ranging from concern that REMAS has slowed down the drug approval process to statements that the FDA has not clearly defined its message.
Janet Woodcock, MD, director of the FDA's Center for Drug Evaluation and Research has described REMS as "important safety strategies."
The law governing REMS is included under Section 505-1 of the Federal Food and Drug Administration Amendments Act of 2007 (FDAAA). FDA has the authority to require REMS if the FDA determines it is necessary to ensure that a drug's benefits outweigh its risks.
Under REMS, the FDA is required to obtain input from patients, physicians, pharmacists, and other healthcare providers "about how the elements to assure safe use for one or more drugs may be standardized so as not to be unduly burdensome on patient access to the drug," according to the petition.
REMS components include medication guides; patient package inserts; a communication plan for healthcare providers; requirements for those who prescribe, dispense, or use the drugs; and a timetable for REMS submission.
In the past three years, the FDA has approved about 90 REMS for new drugs and has required REMS for many new products. For the most part, it has failed to seek input from the public as stated under the law, Kaiser Permanente said.
"To our knowledge, neither of these statutory requirements have been met," according to Kaiser Permanente. "As a result, FDA is imposing REMS development without due consideration to existing healthcare delivery systems."
Incentive-based health promotion programs enhance physical wellness and reduce healthcare costs, according to a study released today.
Specifically, members who participated in fitness-related activities within an incentive-based health insurance wellness program had significantly lower health costs, according to the study published in the January/February issue of American Journal of Health Promotion.
Participants who were active in fitness activities also were less frequently admitted to a hospital and the length of stay was significantly less, the study showed.
As employers struggle with increasing healthcare costs and a prevalence of chronic diseases, "more and more are turning to population health management programs as a solution," says Arthur C. Carlos, CEO of the Vitality Group, which sponsored the study. The Vitality Group is a member of Discovery Health, South Africa’s largest private insurer. In the U.S., the Vitality Group runs an independent health improvement program.
"Incentive-based wellness programs are designed to change behaviors and improve the health of their members," Carlos says. "By improving health in a sustainable way, it is possible to reduce costs over the long-term."
The study examined medical claims over a year filed by nearly 950,000 adult members of Discovery Health. Of the members, more than 62% registered for Vitality, an incentive and reward-based health promotion program offered by Discovery Health to its members.
Health promotion programs are receiving "renewed attention with the advent of consumer-driven health plans," the study noted. "These new-generation health plans offer member-controlled health savings accounts, with the unique feature of carrying balances forward from year to year, thereby encouraging personal responsibility and promoting healthy behaviors," according to the study.
Conclusive evidence for "the long-term effectiveness of incentive-based health promotions programs is lacking," according to the study, adding that more research needs to be carried out. "Knowledge of healthy practices and providing access to wellness programs does not necessarily translate into increased participation in these programs."
"The rise in incidence of chronic disease and associated healthcare costs is unsustainable," says Deepak N. Patel, MD, University of Capetown and senior clinical specialist for Discovery Health. "Although more research will need to be done, this study is encouraging as it shows a positive correlation between engagement in health promotion and lower healthcare costs."
The research showed that "not only were costs per member decreased based on activity level, but the same pattern was demonstrated for admission rates," according to a Vitality press statement.
The Nebraska senator who gave the Democrats what they wanted on health reform now doesn't want what they want to give him in return.
After waves of protest about the potential illegality of the deal in which Nebraska was allegedly promised millions of dollars in Medicaid funds, Sen. Ben Nelson, D-NE, told Democratic leadership he "reiterates" that all states should be given "the same treatment." In other words, he told his colleagues "thanks, but no thanks."
So far, there has been no response from party leaders.
But Nelson is one of the few lawmakers refusing what many describe as "pork" projects in the healthcare reform bill, in which pet projects and favors are heaped on the Senate and House members in exchange for their votes, according to David Williams, vice president of watchdog group Citizens Against Government Waste.
"It's fascinating because whatever Congress does—whether they are working in a conference, or whatever—deals are being made," Williams says. Too often, many of the projects slip below the mass media radar because they "don't have sex appeal. "
The "giveaways"—as Citizens Against Government Waste describes them"—include:
$300 million in Medicaid subsidies for Louisiana. It was a favor for Sen. Mary Landrieu, D-LA, who provided one of the last remaining votes needed by Democrats in the Senate.
A proposed grandfather clause would allow Florida residents to get a discount in Medicare Advantage. The Tampa Tribune reported that 80,000 Floridians would be impacted by the proposed cuts—as well as thousands of other residents in New York, California, New Jersey, and Oregon.
A proposal would restore a Medicaid Disproportionate Share Hospital (DSH) allotment to support Hawaiian hospitals that care for significant numbers of Medicaid and uninsured patients. The proposal is expected to provide $100 million for Hawaii hospitals through 2019. The state of Hawaii will have to provide matching funds to draw down the federal money.
One proposal amends the Medicare Prescription Drug, Improvement and Modernization Act of 2003 so that hospitals in Michigan and Connecticut have an option to receive benefits under section 508 if it means higher payments. Section 508 corrected geographic inequities in wage index-related payments for approximately 120 hospitals, but only for a three-year period.
The proposal calls for Medicare coverage for individuals exposed to environmental health hazards in or around the geographic area subject to an emergency declaration as of June 17, 2009. This addition is seen to help the town of Libby, MT. According to the Washington Post, "Sen. Max Baucus, D-Mont. secured Medicare coverage for anybody exposed to asbestos—as log as they worked in a mine in Libby, Montana."
Under the Senate health bill compromise that sought Nelson's support, Nebraska was blessed with other presumed favors, according to critics. For instance, under the plan, Nebraska insurance company Mutual of Omaha would see less impact from a $10 billion-a-year industry-wide tax on health insurance providers under a deal worked out between the Senate Democrats and Nelson. There is no indication that Nelson has sought to rescind the Mutual of Omaha deal.
Already, favors that have become widely publicized have taken a life of their own, with their own special monikers, including the "Louisiana Purchase, " referring to Sen. Landrieu's vote and the "Cornhusker Kickback Working Group," regarding the Nebraska issue, according to Williams. He adds that other favors are woven through complicated legislation, such as Medicaid payment, and are barely noticed.
There is much talk—and hope—about pilot and demonstration projects included in both health reform bills. Proponents say the projects can show where to save money while exploring new ideas that affect health plans, hospitals, doctors, and patients.
These projects include plans to provide comprehensive care to insured people at reduced fees and proposals to provide assistance to community hospitals.
Simply put, it's easier to put these projects on Capitol Hill legislative agendas than to carry them out. In fact, the U.S. experience with some of the demonstration and pilot projects has been, to say the least, "challenging," according to the Centers for Medicare & Medicaid Services.
Whether easy or difficult, experts say there are lessons to be learned in implementing demonstration and pilot projects.
Joane H. Goodroe, a senior vice president for innovation for VHA Inc, a Irving, TX-based national network of not-for-profit healthcare organizations, says it is vital that healthleaders review the success of such plans before implementing them.
"The number one thing—these pilots do not do well if the data isn't organized," Goodroe says. "Sometimes the released data look very good, and the results seem to be good, but if you pull back the covers, the data systems were not set up in a detailed enough way in which it should have been—to have all the clinical, utilization and cost data together, right there. … This is definitely hard work."
Goodroe has been involved in putting together a number of what she terms successful "gainsharing" programs, which have been identified by the government as "an arrangement in which the hospital gives physicians a percentage share of certain reductions in the hospital's costs for patient care attributable in part to the physician's efforts."
As Goodroe sees it, under these gainsharing programs, she works to capture data during the course of patient care, measure baseline costs, and identify potential waste areas. Gainsharing is a part of the existing demonstration program landscape in 2010. Under the current Senate health reform bill, expanding"gainsharing demonstration" is proposed, under the title of "Encouraging Development of New Patient Care Models."
While she's excited about the possibility of these projects, Goodroe maintains concern about the process in which some demonstration and pilot projects are conducted. And she isn't the only one with some angst about how projects are put together—so is the Centers for Medicaid & Medicare Services
A year ago, CMS reviewed seven demonstration projects involving 300,000 beneficiaries in 30 programs, related primarily to disease management in fee-for-service Medicare. The programs included provider-based, third-party, and hybrid models. Among them were programs for a coordinated care demonstration; Medicare disease management for the severely chronically ill; disease management for duel eligible beneficiaries; and chronic care improvement.
The demonstrations have been inherently complicated, and therein lies the rub, according to the report prepared by CMS analysts David Bott, Mary Kapp, Lorraine Johnson, and Linda Magnois, who is director of the CMS Medicare Demonstration Group. There are often multiple programs involved with each one, with a different combination of providers, beneficiary populations, geographical areas, and different testing interventions. In addition, most of the program's participants made changes during their period of operations, such as tweaks to outreach and beneficiary assessment.
Noting all these potential obstacles in putting together smooth demonstration projects, the CMS determined that "reducing costs sufficient to cover program fees has proved particularly challenging."
CMS added: "Results from the CMS demonstrations have not shown widespread evidence of improvement in compliance with evidence-based care, satisfaction for providers or beneficiaries, or broad behavioral change."
"Only a few programs have produced financial savings in fees," it added.
Although the CMS carried out the study in 2009, CMS officials say that the work is "still timely today."
Goodroe agrees that keeping demonstration and pilot programs in check is a challenging task. A common thread for these projects, especially in pilot and demonstration studies, is ensuring that data is foolproof, she says. It is important to accurately assemble data "to determine areas for waste reduction and improve the quality of patient outcomes."
In a white paper, entitled "Keys to Successful Health Care Reform," Goodroe wrote it's necessary for healthcare leaders to "review the success of various health care reform efforts in the past, learn from these models and employ the key components required for success." Goodroe wrote the paper for Goodroe Health Solutions, which is a part of VHA.
But it's not an easy task with the existing healthcare structures, including the fact that there is a "lack of existing national data systems with reliable utilization," she says. "This is a matter of vendors, hospitals, and physicians realizing that most existing systems need to be retooled to meet these needs, one service line at a time."
"Significant barriers exist in the structure of our current health system and the laws that govern it," she says. "These barriers prevent us from transitioning to a focused re-engineering effort that other industries normally employ."
Operating effectively, pilot studies and demonstration projects can shed light on the myriad ways the health care system can improve itself. But if they are not carried out successfully, they are just another dust-collector, another part of what Goodroe calls the "hidden cost of health care."
One of the more controversial aspects of health reform has more to do with teenagers than health leaders—a proposal in the Senate bill that would allot $50 million for states to continue abstinence education programs.
The abstinence programs focus on encouraging teenagers to delay having sex until marriage to reduce pregnancies and sexually transmitted diseases. Opponents say they are misguided and have no place in a health reform bill.
Valerie Huber, president of the National Abstinence Education Association, which is lobbying to maintain the abstinence funding, says the health reform bill is now the only hope for continued funding, which expires on June 30.
"We are hopeful the Senate language will prevail," Huber says, referring to House and Senate conference on the health reform bill. The House did not include the abstinence program in its version of the health reform legislation.
"I think it's up in the air," Huber says of the final Congressional decision. "This is a grassroots issue and we're relying on our members to communicate to members of Congress."
The fallout of Scott Brown's election victory in the Massachusetts Senate race, which gives the GOP enough votes to filibuster health reform, or at least possibly force a compromise, is among the "elements in play" that could determine the fate of the abstinence program, Huber says.
Huber's organization says the abstinence programs serve teens by giving them the skills necessary to avoid sexual activity.
Under former President George Bush, abstinence programs received $150 million per year. President Obama declined to place funding in this year's budget for an abstinence only education program. Abstinence education funding was restored in the Senate healthcare bill as Senate Majority Leader Harry Reid, D-NV, reconciled versions of bills offered by the Senate Finance Committee.
But James Wagoner, president of the Advocates for Youth, a Washington-D.C. advocacy program, says there is no scientific evidence that abstinence only programs work. The funding shouldn't even be in the health bill, he says, adding, "It has nothing to do with people who don't have health insurance . . . But that's how Congress operates."
Wagoner supports comprehensive education programs, which includes abstinence and contraception instruction. Both houses of Congress and the federal budget have funds slated for the comprehensive education programs.
Abstinence programs have been wasteful, he says. "More than $1.5 billion has been spent over the past decade for a program that in reality has been a complete failure," Waggoner says.
What happens to the abstinence program in a House and Senate conference remains to be seen, especially with the Massachusetts vote Tuesday. "The political dynamic is in abeyance," Wagoner says.
Generally, employers, from small privately held companies to large multi-national firms, are taking a critical look at their health benefit strategies and the value they derive from it. Indeed, they are looking to their health plan providers for information technology and other strategies to help reduce waste in healthcare spending and better engage employees in managing their health, according to the study.
"Employers recognize that it's better to manage the health of their workforce than to manage the cost of illness, and they want their health plan to help manage the entire health continuum," said Paul Veronneau, principal and U.S. healthcare payer leader for PricewaterhouseCoopers. "There is only so much insurers can do to manage health and cost through provider discounts or on the back end of a claim. This is an opportunity for health insurers to look beyond traditional strategies and get more aggressive about healthcare quality and value."
In its report, entitled, "What Employers Want from Health Insurers in 2010," PricewaterhouseCoopers analyzed responses of nearly 250 employers. The analysis examined key service areas, such as financial, customer service, and claims administration.
Major findings include:
Overall satisfaction of health insurers by large employers has decreased from 64% in 2008 to 59% in 2009.
Small employers continue to be less satisfied with health insurers than large employers, with overall satisfaction at 52% in both 2008 and 2009. The gap between large and small employers is narrowing as large employer "satisfaction erodes," the report said.
About 60% of employers said they would further increase cost-sharing for healthcare with their employees in the year ahead.
The importance of wellness programs continues to be the area showing the greatest gap between large and small employers, the study found. Nearly 80% of large employers indicate that wellness programs are important to them, compared to 57% of small employers.
But "wellness programs and personal health records are the two service areas that experienced the largest increase in importance among small employers" since 2008, according to the study.
Many employers are finding that simple financial incentives, such as cash, gift cards, and annual premium savings, are no longer working as a way to engage employees. However, interest in personal technology tools, such as personal health records and online comparison tools, are becoming increasingly popular.
Based on the PricewaterhouseCoopers analysis, the report recommended that:
Insurers should be a consultative partner with employers to help improve workers' health and advocate for employer health strategies.
Take a more active role in waste reduction.
Offer better strategies for engaging employees in wellness and disease management programs.
Provide better data to build workforce profiles to help employers better understand the health of their workers and find intervention strategies.
Provide education that will simplify health plans and benefits.
It's a move of expansion and contraction for Detroit-based Henry Ford Health System, which plans to close 86 inpatient beds at Henry Ford Cottage Hospital in Grosse Point Farms, MI, to make way for new outpatient medical services to serve a burgeoning elderly population in the area.
The 20-bed medical-surgical unit as well as a 30-bed psychiatric unit and 36-bed rehabilitation unit program will be closed at Cottage Hospital, whose patients will be relocated to other Henry Ford campuses on or before April 3, officials said. Henry Ford purchased the Cottage Hospital in 2007 from Bon Secours Health System.
Henry Ford seeks to "better meet the growing needs of an aging population and reflect the increased demand for outpatient healthcare," says David Olejarz, a spokesman for Henry Ford Health Systems.
The need for outpatient services is considered strong in the Detroit area's eastern suburbs, especially with a growing elderly population.
The changes were made after Cottage Hospital reported fiscal losses, though officials did not provide details, except to say the surgical unit was running at half its daily capacity. The hospital, which now employs 450 people, will cut jobs, but there is no specific number.
Henry Ford officials said a top priority was to preserve as many jobs as possible. The company said it seeks to match employees impacted by the changes with open positions throughout its health system.
Under the new plan, Cottage Hospital will operate as a large multi-specialty outpatient center with more than a dozen services that include a:
Specialty program for seniors
Center for women's health
Sports injury treatment center
"We are looking forward and are committed to continuing to partner and work side-by-side with the private practice physicians who will play an integral role in the long-term success of the Cottage," says Mark Kelley, MD, vice president for the Henry Ford Health System and chief executive officer of the Henry Ford Medical Group.
The center will be modeled after Henry Ford's medical center in Dearborn, which sees more than 350,000 outpatient visits a year, officials said.
More than 30 additional physicians will be recruited at Cottage Hospital to provide a wide range of primary care and specialty services, says Robert Riney, chief operating officer for the Henry Ford Health Systems. Emergency care and other services, such as radiation oncology and physical and occupational therapy, will remain at Cottage Hospital.
