A bipartisan group of 30 members of Congress last week introduced legislation for healthcare reform measures it says have broad support and could be enacted without rancorous debate (See related story, p. 2). The bill, sponsored by Reps. J. Roy Rowland (D-Ga.) and Michael Bilirakis (R-Fla.), includes insurance reforms to enable workers to change jobs without losing coverage and to limit restrictions for people with pre-existing medical conditions, expanded access for the uninsured through community health centers, malpractice reform and administrative simplification.
Blue Cross and Blue Shield of Michigan has lost its contract with the federal government to process Medicare claims, which amounts to about $52 million in business, the insurer confirmed last week. The decision not to renew the contract, which expires in September, follows an investigation by the FBI into whether Blue Cross falsified records of hospital audits (Jan. 3, p. 18). The 680 employees whose jobs are directly tied to Medicare will be hired by the organization that takes over the claims, likely a Blues plan in another state, HCFA told Blue Cross and other sources. Since the allegations of exaggerated audits, Blue Cross and Blue Shield of Illinois has been temporarily handling the $15 million-a-year hospital portion of Medicare business. A spokesman for Blue Cross said the company had been informed of the decision. He said company executives hoped to change HCFA's mind.-Associated Press
Two Roman Catholic hospitals in New York City will be integrated under an agreement between the Archdiocese of New York and the Sisters of Charity of St. Vincent de Paul of New York. The agreement links 229-bed St. Clare's Hospital and Health Center and 788-bed St. Vincent's Hospital and Medical Center of New York. A third hospital, Cabrini Medical Center, sponsored by the Missionary Sisters of the Sacred Heart, has decided not to be part of the organization (Nov. 8,, 1993, p. 14). Patricia Cahill, director of the health and hospitals department for the Roman Catholic Archdiocese of New York, said task forces representing both organizations have been formed to develop the organization that will govern the two hospitals. Meanwhile, the archdiocese continues to discuss the possibility of creating an integrated delivery network with its other hospitals and nursing facilities in Manhattan, the Bronx and Westchester County.
Mullikin Medical Centers has restructured its business operations and tapped Sharon Jose, formerly Mullikin's associate administrator, as top administrator of its 99-bed Pioneer Hospital in Artesia, Calif. John S. McDonald, who served as both Pioneer's administrator and chief executive officer of Mullikin, will remain as CEO of the corporate activities of the 430-physician multispecialty group, its prepaid healthcare business and various subsidiaries at administrative offices in Long Beach, Calif. Mullikin, which provides prepaid healthcare services to 300,000 enrollees in 22 managed-care plans statewide, also announced last week plans to acquire the Stockton, Calif.-based Lincoln Family Medical Group, a 12-physician primary-care medical group in the San Joaquin Valley providing care to 8,300 managed-care enrollees and 15,000 fee-for-service patients. Terms of the transaction and a purchase price weren't disclosed.
More than half of all emergency-department visits weren't for emergencies in 1992, according to a study released by HHS. The study found that of the 90 million visits to hospital emergency departments, 55% were non-urgent. While people older than 75 had the highest rate of emergency-department visits (56 visits per 100 people), those younger than 24 had the highest rate of non-urgent visits at 61%. The most common cause of injury was accidental falls (7.7 million visits) followed by motor vehicle-related injuries (4.1 million visits).
Park Ridge, N.J.-based Medco Behavioral Care Corp. has acquired Houston-based Benesys. Both are behavioral healthcare companies. Though terms of the deal weren't disclosed, the companies said Benesys will become a subsidiary of MBC, creating a provider market in the Southwest comprising 1.6 million managed-care enrollees. Benesys is expected to continue to operate under existing management, led by James F. Considine, M.D., the company's president and chief executive officer. MBC's national managed-care network serves 12.5 million people through 20,000 providers.