For-profit healthcare leaders were beaten to the punch in the debate over not-for-profit hospital conversions by the industry's devoted gadfly, Linda Miller of the Volunteer Trustees of Not-For-Profit Hospitals.
Miller already had printed a 42-page booklet warning communities to watch out for their interests when not-for-profit hospitals go for-profit. As of last week, she had distributed 8,000 copies to interested parties, including all state attorneys general.
That's when for-profit sector leader Thomas Scully, president of the Federation of American Health Systems, confirmed that he plans to discuss his views on "reasonable oversight" of such deals with a number of attorney generals in key states.
The federation believes regulations governing the transfer of not-for-profit hospital assets should be applied evenly to both for-profit and not-for-profit buyers.
Miller accused the federation of attempting to obscure the debate.
"Our issue is what happens to those charitable dollars in conversions," Miller said. "Is there full and fair compensation to the community? There are certainly very important issues that come up in the transfer of one not-for-profit to another, but they are different issues."
Miller, president of a small Washington-based group representing not-for-profit healthcare interests, has been advocating aggressive state oversight on not-for-profit conversions since mid-1995. A number of hospital sales to for-profit companies have occurred virtually in secret with no party representing the community's interests, she said.
Miller's efforts included a September 1995 presentation to a joint meeting of state attorneys general and state charity officers.
What's more, Miller said she is talking with 14 states about policing not-for-profit hospital and HMO conversions. Seven of them-Colorado, Massachusetts, Michigan, New Hampshire, New Jersey, Ohio and Virginia-are or soon will be drafting legislation, she said.
Last year, laws took effect in California and Nebraska that require public disclosure of the terms of such sales.