While the House was close to a vote on its own version of health insurance reform last week (See related story, p. 8), the leading Senate health insurance reform plan picked up new support, with the American Nurses Association and the Independent Insurance Agents of America separately endorsing the plan. The Senate plan, sponsored by Sens. Nancy Kassebaum (R-Kan.) and Edward Kennedy (D-Mass.), is more streamlined than the plan that was approved by House committees. IIAA representatives met with President Clinton before announcing their endorsement. Afterward, Clinton reiterated his support for the Senate plan.
Cleveland Clinic Hospital in Fort Lauderdale, Fla., must implement changes in its emergency department or risk losing its ability to receive payments for treating Medicare patients. The 110-bed hospital was notified last month by HCFA it had 90 days to correct emergency room violations, said Ed Hicks, a HCFA official. The agency was prompted to take such action after a state agency investigating on its behalf found the hospital's emergency room record-keeping and physician-notification procedures didn't meet HCFA standards. At least one patient's complaint led to the investigation. Henry Honahan, a 58-year-old Fort Lauderdale resident, complained to a Florida healthcare agency that he was improperly treated in the hospital's emergency room and at times during a seven-day hospital stay last year. Honahan made his allegations public in the South Florida Business Journal. The hospital acknowledged in a written statement last week that it received a letter from HCFA Feb. 9 "indicating that after a review of select emergency department records, some of the documentation and notification procedures in those cases were not in compliance with standards set by HCFA. We took this situation very seriously and immediately appointed an executive level task force to review HCFA's concerns. At no time was patient care compromised." -Crain News Service
Vermillion County Hospital in Clinton, Ind., has moved a step closer to signing a long-term lease with Union Hospital in Terre Haute, Ind., and surrendering its license. The hospital board unanimously approved a resolution last week authorizing the negotiation of a lease and operating agreement with Union on or before April 22. If the board approves a lease with Union, the Vermillion County facility would operate under Union's state hospital license. After state police and other officials launched an investigation last spring into suspicious deaths at the county hospital, the facility's financial situation worsened. Administrator John Ling resigned in October, and the hospital has been under interim management since. Columbia/HCA Healthcare Corp. has offered two partnership proposals, including a management agreement, to Vermillion County Hospital. Also, Alliant Health System, Louisville, Ky., has surveyed the hospital with the option of presenting a management proposal. The hospital reported more than $2 million in losses in 1993 and 1994. An additional drain on hospital funds occurred last year after a nurse's report revealed the death rate in the intensive-care unit more than tripled during a 22-month period ending last March.
The drive toward managed care is putting the squeeze on AIDS treatment, activists told the Eighth National AIDS Update Conference last week in San Francisco. "The days of Marcus Welby are over," said Mary Fisher, an AIDS patient and daughter of a prominent Republican fund-raiser, Max Fisher. "In the world of managed care, HIV-infected people are as popular as Jesse Helms at a gay pride rally," Fisher said. "Three words are poisonous to HMOs: chronic, progressive and terminal." Many participants said managed care's approach to medical cost containment can offer advantages to AIDS patients, including increased emphasis on prevention programs and convenient one-stop shopping for care. But in the insurers' drive to compress healthcare costs, patients unlucky enough to be very sick-and the doctors who care for them-say they are being squeezed out (See related story, p. 12).
Columbia/HCA Healthcare Corp. and Riverside Health System in Newport News, Va., have agreed not to discuss merging with other hospitals in the Norfolk, Va., area during the next 90 days, a Riverside spokeswoman said. Neither Riverside nor Columbia officials would comment on details of the pact or any pending negotiations. Columbia owns 13 hospitals and an ambulatory surgery center in the state. Riverside is one of three not-for-profit regional chains in eastern Virginia, operating four hospitals. If Columbia were to enter into a partnership or merger with Riverside, it would gain control of the most profitable system in the eastern part of the state, said Paul Boynton, executive director of the Eastern Virginia Health Systems Agency. The Virginia Health Services Cost Review Council said Riverside earned a $45 million profit on revenues of $414.6 million in 1993. The pledge also may affect the future of Williamsburg (Va.) Community Hospital. Both Columbia and Riverside recently submitted bids to partner with Williamsburg Community (See story, p. 39). Their pledge would apparently preclude them from continuing their discussions with Williamsburg, Boynton said. Officials at Williamsburg could not be reached for comment.