House Speaker Newt Gingrich last week announced at the American Hospital Association meeting in Washington that he wants to establish a monthly "corrections day" to rid the world of "dumb" government regulations.
"On corrections day, we take the dumbest things the federal government is doing and just abolish them," Gingrich said. He then asked for suggestions. Gingrich said eventually, "government agencies will realize that it's not fun to be the target of corrections day."
AHA President Richard Davidson said later that his No. 1 corrections-day item would be HCFA's hospital billing rules, which Davidson said were hospitals' "biggest (public relations) problem."
Hooked.There's no turning back once you start capitating, explains the December 1994 issue of Integrated Healthcare Report, Lake Arrowhead, Calif.
A passage called "Capitation: The `Cocaine of Healthcare,'*" reads in part: "When a physician or hospital starts to dabble in capitation it gives them a quick high. When they have 10% to 15% of their business capitated, it gives them a false sense of security that they are now `doing' managed care, or capitation. That good warm feeling comes as a rush twice a month" when they're paid and notified of new patients.
"When the capitation percentage rises to 20% to 30% of their business they are `hooked or addicted.'*" They "realize that `capitation' is no longer a hobby.
"When the capitation percentage reaches 45% to 55%, the provider is `mainlining.' By this time physician behavior has changed."
Quaking.Holy Cross Medical Center in Mission Hills, Calif., spent about $10 million to fix its damage from last year's earthquake. Now, it reports spending $50,000 to repair a cracked reputation.
A Jan. 23 article in the Los Angeles Times questioned the safety of the medical center. It took the return of a California Seismic Safety Commission member from a fishing tournament in Mexico, plus a full-page ad in the Times placed by the hospital, to start clearing the rubble.
In an article headlined "State let damaged hospital remain open," the Times quoted Pat Snyder, a commission member, as demanding to know how the quake-damaged hospital could stay open. A smaller headline stated that the commission criticized the Office of Statewide Health Planning "for not heeding reports of its own engineers" that the 309-bed Holy Cross "could collapse in another temblor."
The trouble was, all this was news to the Seismic Safety Commission. Tom Tobin, its executive director, said it "has never concluded that Holy Cross Medical Center is structurally unsafe." It was also news to the Office of Statewide Health Planning, a spokeswoman there said.
Snyder was the only commission member quoted in the story. For a week after the story appeared, she was at the tournament and unavailable for comment. Now, she says she "didn't `demand,' I asked a question" at the commission's December 1994 meeting. "I never felt at any time that the building was ready to collapse. My question was, `What is the determining standard for whether a (quake-damaged) hospital stays open or closed?'*"
Life support.University Hospital in Albuquerque, N.M., is developing a unique expertise-becoming an intensive-care unit for struggling rural hospitals.
Unlike management companies that contract with troubled hospitals through long-term contracts, University handles them as it would an ICU patient. Get them back on their feet and on their way.
"From my perspective, if a hospital is locally owned and operated, (the community) will be more concerned about its survival," said Pamela Galbraith, the hospital's administrator for medical services.
Recently, the hospital stepped in to help Mimbres Memorial Hospital, Deming, N.M., after the hospital canceled its management contract with Epic Healthcare Services, a Dallas-based subsidiary of Healthtrust. Officials of the county-owned hospital got upset with Epic after the management company installed a new computer that wasn't sending out all the bills. That led to a cash crunch of $1.1 million. Epic has since settled the matter with a $455,000 payment to the hospital.
University Hospital stepped in to be interim manager, the third time it's done so with a rural hospital in the past two years. Its previous patients were Guadalupe County Hospitalin Santa Rosa, N.M., and Sierra Vista Hospital in Truth or Consequences, N.M.
A train runs through it.A four-block urban renewal site in downtown Worcester, Mass., is perfect for a new $160 million healthcare facility and parking garage planned by Fallon Healthcare System. There's just one problem: The Providence and Worcester Railroad runs through the middle of it.
Trains would hit the proposed hospital head-on. So planners are taking corrective measures that will cause construction to chug along at less than full steam. Plans are to submerge the tracks and bend the route slightly to create a tunnel between the hospital foundation and the parking deck, said Lloyd Hansen, project director for the joint construction venture between St. Louis-based McCarthy and Framingham, Mass.-based Perini Corp.
"It'll be vibration-isolated from either structure, so there shouldn't be any sense of a train coming through," said Hansen. But getting the tunnel built won't be easy.
Freight traffic can't be interrupted, so a temporary bypass will be built to take trains about 100 feet east-through the parking garage site-while the tunnel and hospital are built.
That's not all. The state highway department will be building new viaducts under the train tracks at both ends of the property, which will further delay the hospital construction.
Quotable."I've still got a lot to learn about Washington. Yesterday, I accidentally spent some of my own money."-Freshman Sen. Fred Thompson (R-Tenn.), remarking on his first few weeks in office.