The National Committee for Quality Assurance broadens its Health Plan Employer Data and Information Set, or HEDIS, to gauge quality of care and illness prevention. It requires more cooperation between plans and providers starting i n 1997. Also during the year, the NCQA releases the Quality Compass database, which gives employers access to comparative data on health plans for the first time. HCFA announces it will require Medicare HMOs to comply with HEDIS re quirements starting in 1997.
Thomas Adams, former leader of the State Medical Society of Wisconsin, becomes CEO of the Englewood, Colo.-based Medical Group Management Association and tries to increase its clout in Washington.
President Clinton signs the Kassebaum-Kennedy bill, formally known as the Health Insurance Portability and Accountability Act, the first significant healthcare reform in years. It mandates insurance portability and coverage for pre-existing conditions, establishes a demonstration of medical savings accounts and updates fraud-and-abuse rules. The impact of countless other provisions has yet to be measured.
Columbia unveils the first full-scale national branding campaign by a hospital chain with ads featuring a goofy guy who asks a male farmer where he would go if he were about to give birth. Columbia's attempt to boost its image goes too far at times, such as when the agency that oversees the Malcolm Baldrige National Quality Award reprimands the chain for misrepresenting its participation in a pilot awards program for healthcare providers. Columbia's image later is put to the test when 60 Minutes investigates its controversial purchases of not-for-profits.
Long-awaited federal guidelines relax antitrust standards for networks of physicians that are not financially integrated but share clinical and quality information. The guidelines also give a boost to provider networks that want to compete with insurance companies or operate in rural areas.
Larry Mathis steps down after 13 years as president and CEO of Methodist Health Care System in Houston. Mathis is well-known for fighting a 1991 lawsuit by the Texas attorney general, which contended that the cash-rich not-for-profit Methodist Hospital didn't provide enough charity care to justify its tax-exempt status.
A federal judge approves the merger of two not-for-profit hospitals in
Grand Rapids, Mich., marking the third time in 16 months that a federal district court judge has thrown out a federal antitrust challenge of a not-for-profit hospital merger. In each case, it was faith in the hospitals' community-minded board and not-for-profit mission that appeared to sway the judge in favor of approving the deal.
Tenet Healthcare Corp. announces its purchase of OrNda HealthCorp for $3.1 billion. The deal increases the holdings of the No. 2 hospital chain to 126 hospitals from 76, but its revenues remain dwarfed by leader Columbia.
Voters keep Clinton in the White House and Republicans in control of Congress, ensuring no dramatic budget or reform measures. The first order of business: controlling the growth of Medicare.
Chicago's Cardinal Joseph Bernardin, an outspoken proponent of not-for-profit healthcare systems, dies of pancreatic cancer.
Andrew Stern, newly elected leader of the Service Employees International Union, advocates partnering with public health systems to fight the corporatization of healthcare.
Florida Attorney General Bob Butterworth files a lawsuit against the sale of not-for-profit Boca Raton (Fla.) Community Hospital to a group of not-for-profit hospitals, saying he wants to ensure the deal is "consistent with the wi shes" of the facility's donors. The case could lead to closer scrutiny of purchases of charitable assets by not-for-profit hospitals. Previous litigation involved deals in which for-profit companies were the buyers.