MINNEAPOLIS-Sending caregivers to new mothers' homes in hopes of stemming violence is one of several joint initiatives being considered by a new coalition of Minnesota HMOs, hospitals and public-health agencies.
Another project would have hospitals gathering data on the causes of broken bones, bullet wounds and similar injuries. Such information could let health plans break out the per enrollee, per month cost of violence. Then, employers might be persuaded to pay for classes on parenting skills and other violence-prevention efforts, advocates of the project said.
The board of the Health Care Coalition on Violence will consider the final slate of programs by early next month and hopes to implement them starting in 1997. At that point, a budget would be established to finance the programs. The coalition hopes to solicit private contributions to fund the programs.
The coalition includes all major healthcare groups in Minnesota, including the state medical, hospital and HMO associations. It was formed earlier this year at the urging of Gov. Arne Carlson's Task Force on Violence as a Public Health Problem.
The task force issued a report in January listing 10 major strategies to reduce violence, such as gathering better data, developing practice guidelines and expanding workplace programs. It will continue in an advisory role as the coalition carries out its recommendations.
Violence is a health problem comparable to major epidemics, said David Strand, coalition chairman and system vice president of Allina Health System, which runs 19 hospitals and a nearly 1 million-enrollee health plan.
The healthcare costs of violence were estimated at $10 billion nationwide in 1987 and $200 million in Minnesota alone, according to a January report of the task force.
Tracking actual costs is incredibly difficult. Violence causes psychological as well as physical injury. Even the physical injuries due to violence are tough to count because hospitals and clinics don't always record necessary information.
Coalition members plan to push expanded use of billing codes that identify the cause of violence, Strand said. E-codes, short for "external code of injury," will tell payers if a broken wrist was caused by assault, for example.
"We need a much better system of tracking," said George Halvorson, president and chief executive officer of HealthPartners, a 650,000-enrollee health plan and a coalition member. "There's an awful lot of accidents. People are getting their cheeks sewn up all the time."
Other coalition initiatives likely will include a pilot project to send caregivers to the homes of all new mothers, Strand said. Preventing child abuse will be part of the curriculum on caring for new babies.
Meanwhile, coalition members are continuing their own efforts. For example, HealthPartners is planning to teach staff members throughout its system how to recognize and treat domestic abuse. The HMO created a training video to help clinicians better respond to abused women.
"Doctors don't know how to recognize violence, and they don't know how to intervene," Halvorson said. "What does a fist-mark look like? What does a boot-mark look like? We can't deal with (all causes of violence). But we can get people to recognize the abuse."
MILWAUKEE-Froedtert Memorial Lutheran Hospital and Curative Rehabilitation Services entered an operating alliance to share select resources and develop joint programs for adult medical rehabilitation. Their two-year accord was official in late September. Curative already provides rehabilitation services at Froedtert under a long-term contract. It will have an ownership stake in future ventures. "This is sort of like an engagement," said Curative spokesman Paul Daniel. "We want to make sure both organizations work well together. (A merger or closer relationship) might be down the road, but that hasn't been talked about." Curative, which provides services at nine sites, earned $391,000 on revenues of $18 million in 1995. Froedtert, a 241-bed hospital, earned $4.5 million on operating revenues of $142.4 million in 1994, according to the latest data available from HCIA, a Baltimore-based healthcare information company.
MISHAWAKA, Ind.-Sisters of St. Francis Health Services of Mishawaka last week announced several restructurings, including the promotion of Kevin Leahy as the Roman Catholic system's first lay president and chief executive officer. Since 1992, Leahy has been president and CEO at the system's St. Francis Hospital and Health Centers in Beech Grove, Ind. He replaces Sister Jane Marie Klein, who will become chair of the eight-hospital system's board. In turn, Klein replaces Sister Rose Agnes Pfautsch, provincial superior for the system's sponsoring order, Sisters of St. Francis of Perpetual Adoration. Pfautsch will continue to serve on the system's board but will focus her attention on corporate leadership of the order. All changes will become effective Nov. 1. Robert Brody, an executive vice president at St. Francis Hospital and Health Centers, will replace Leahy.