The American Hospital Association and other provider groups were crowing last week at being mentioned by President Clinton in the first of two debates between Clinton and the Republican nominee, retired Senate Majority Leader Bob Dole (R-Kan.).
In fact, they said it was the first time in anyone's recollection that the AHA, the Catholic Health Association or the American Nurses Association was referred to in a presidential debate.
But they shouldn't have been surprised.
The week before the debate, the White House called several provider groups asking for any documents they have published on the effects of Medicare spending-growth reductions on hospitals and other providers. Although provider group sources said it wasn't an unusual request, they were somewhat surprised at how Clinton used the information-as ammunition to attack Dole for pushing last year's congressional Medicare reform proposal with House Speaker Newt Gingrich (R-Ga.).
"The American Hospital Association, the nurses association, the Catholic Hospital Association (it's actually the Catholic Health Association) all said hundreds of hospitals could close and people would be hurt badly under the Dole-Gingrich Medicare plan that I vetoed," Clinton said.
Employee stock ownership plans proved to be a popular financing tool among for-profit hospital chains in the 1980s. ESOPs may be coming back, this time among not-for-profits.
Word is several tax-exempt healthcare organizations are considering ESOPs, but so far no such deals have materialized. "There's a lot of interest," confirmed Gary Howell, a partner with Gardner, Carton & Douglas, a Chicago-based law firm. Howell's office has consulted in four or five situations in which hospitals are exploring spinoffs to employed physicians or staff. They include an academic medical center, a municipal hospital and a physician group.
Howell says ESOPs offer a unique combination of benefits. They provide an opportunity for employees, including employed physicians, to become partial owners. Such a structure aligns employees' financial interests with the institution, which can affect such issues as quality of care. ESOPs also enjoy certain tax benefits, he said.
Louisiana healthcare providers looking for solutions to the state's Medicaid woes weren't given much, if any, hope earlier this month during HCFA Administrator Bruce Vladeck's trip to New Orleans.
After a closed-door meeting with policy wonks from the state and Tulane University, Vladeck addressed a packed room of 300 hospital employees, physicians, residents and medical students at the J. Bennett Johnston Building Conference Center, located across from Tulane University Hospital and Clinics in downtown New Orleans.
"I have no magic beans in my pocket," Vladeck told the crowd. Earlier this year, Congress approved legislation that would help Louisiana avoid a budget catastrophe. The law reduced what the state had to contribute in order to get its $2.6 billion in federal Medicaid dollars. However, the new formula also kicked in a revised payment schedule that requires Louisiana to gradually increase its contributions in the next three years.
In order to get its federal match, Louisiana must contribute $545 million this year, $658 million in fiscal 1997 and $914 million in fiscal 1998. That will be a tall order for a state with 40% of its population uninsured or receiving Medicaid. Among Louisiana's possible options is a state-run managed-care program that would capitate Medicaid payments to providers.
"1997 will be the year of the nitty-gritty reforms of the Medicaid system," Vladeck told the group.
Interest in hospital-based fitness and wellness centers continues to draw interest from healthcare executives. The Association of Hospital Health and Fitness saw attendance triple to 300 at its second annual meeting held Sept. 30-Oct. 2 in New Orleans.
The Evanston, Ill.-based association expanded this year's program an additional day to 21/2 days.
"It's exciting for us because we also had 30 exhibitors this year," said Robin Schuette, director of the association. "There's a lot of interest out there."
The conference's first meeting last year had just a few exhibitors. The AHHF plans to release a report later this year outlining the financial growth in hospital-based health clubs, fitness centers and wellness facilities. It expects the report to include profiles of some 300 hospital-based fitness programs, which may account for $2 billion in revenues in the next two years.
Everyone who works in a healthcare setting gets used to the black humor that breaks the tension of life-and-death situations. Well, those medical Jay Lenos just got another source from which to steal their jokes.
A Vancouver, Wash.-based publisher, Wise Guys, has just come out with the inaugural issue of lite Medicine, a monthly newsletter. Filled with columns, cartoons, jokes, anecdotes and trivia, lite Medicine prescribes a dose of healing humor.
Outliers particularly liked the "Dictation Bloopers" column featuring slip-ups heard by medical transcribers. A good one: "The patient has hammer toes and her feet don't touch the ground."
To subscribe, call 1-888-LITEMED, or on line use http: www.litemedicine.com/litemed.