—MetroHealth System received approval from federal regulators on a complex legal maneuver that could extend Medicaid coverage to as many as 30,000 people in Cuyahoga County earlier than they would qualify for the coverage if the state expands eligibility in 2014 under the Patient Protection and Affordable Care Act. The health system, which is subsidized by Cuyahoga County, has been working on the waiver since the fall of 2011. The plan would extend healthcare coverage for county residents ages 19 to 64 who are uninsured, not eligible for regular Medicaid and have an income at or below 133% of the federal poverty level, which equates to $14,856 for an individual. MetroHealth plans to start enrolling patients immediately. “It doesn't meet the needs of everyone, but it meets the needs of a significant number of our patients,” said John Corlett, MetroHealth's vice president of government relations and community affairs. Because MetroHealth is a public entity, it plans to use its $36 million county subsidy to draw about $64 million in additional federal matching funds to finance the Medicaid expansion, which the health system has dubbed “MetroHealth Care Plus.” The federal approval of the waiver comes after Gov. John Kasich's announcement that he wants Ohio to move forward with an expansion of Medicaid under the healthcare reform law. Expecting an influx of newly insured patients, MetroHealth last year finished tweaking its primary-care operations at its satellite clinics and is doing the same for its specialty service lines. Last October, Cook County in Illinois started enrolling individuals in a similar program on a much larger scale. The Cook County program immediately extended coverage to 115,000 individuals who wouldn't be eligible for Medicaid until 2014.
—Crain's Cleveland Business
—The Cleveland Clinic is the latest hospital system to form a joint venture that aims to address the rising costs of hip and knee implants, stents and other pricey physician preference items. The Cleveland Clinic previously handled purchasing of physician preference items internally and contracted with Premier healthcare alliance on other supplies. The system is moving its contracting to Novation, VHA's group purchasing organization. Under the direction of Dr. Delos Cosgrove, the Clinic's president and CEO, the 11-hospital system has reduced supply-chain costs by $155 million in the past three years, said Bill Donato, executive director of the Cleveland Clinic's supply-chain division. However, he added that there is still a need to further reduce costs and make the supply chain more efficient. “I think everyone would recognize the healthcare supply chain is broken,” he said. The system spends about $1.6 billion a year on supplies and services, including $180 million on implantables. The Clinic owns 60% of the joint venture, Donato said, and while the system is the venture's “No. 1 client,” there are plans to bring in other VHA members, Cleveland Clinic affiliates and others. A Premier spokesman said in an e-mail that the alliance continues to collaborate with “a very large hospital membership in the Ohio region. ...Increasingly, however, our strategies have diverged with those of the Cleveland Clinic.”