If Congress passes provider-sponsored organization legislation being backed by the American Hospital Association, the American Medical Association and nine other hospital groups, it could lead to a financial crisis similar to the savings and loan failures of the late 1980s and early 1990s, says the man who helped clean up the S&L mess.
L. William Seidman, who was chairman of the Resolution Trust Corp. from 1989 to 1992, analyzed the two leading PSO bills in Congress at the request of the Health Insurance Association of America, which opposes the bills.
Seidman says allowing PSOs to enroll Medicare beneficiaries under federal solvency standards "can create some real problems for healthcare consumers and the government, very similar to the problems experienced in the savings and loan debacle."
Under the federal PSO bills, HHS would develop solvency and quality standards for PSOs, which would apply directly to HHS for a license to enroll Medicare beneficiaries under a capitated payment system. Currently, states oversee all Medicare HMOs.
The bills would allow PSOs to count assets such as a hospital or a program toward the solvency requirements. Seidman called these measures "the key financial flaws" in the bills.
The former federal regulator also said that since the federal government would ultimately be responsible for the care of Medicare beneficiaries should a PSO go belly up, there should be a fund created similar to the Federal Deposit Insurance Corp. that would be financed by assessments on PSOs.
Patients as humans.Here's a radical idea proffered at the most recent National Forum on Hospital and Health Affairs: Treat patients like they're human.
According to the healthcare executives preaching this outrageous notion, showing that you care is more than just a nice thing to do. It also can be a moneymaker.
During his speech on how his hospital organized an integrated delivery system, Charlotte, N.C.-based Carolinas HealthCare System President and Chief Executive Officer Harry Nurkin told a crowd of 100 gathered at Duke University that the healthcare industry needs to bring back "feeling, intimacy and relationships" to patient care. Anyone who fears intimacy may pay for it, namely by watching patients leap into the arms of those who care, he said.
The previous day, B. Ned Calonge, M.D., the chief of preventive medicine for the Denver branch of Kaiser Foundation Health Plan, told the crowd that asking patients "How do you feel?" could become the $64,000 question, or however much a physician is being paid in capitation rates.
Doctors need to ask patients how they feel because perception, rather than reality, determines how much a patient will use healthcare services, Calonge said. Because capitation rewards doctors whose patients use few healthcare services, getting an idea of how patients feel can prevent overuse of said services.
Dramatic venue.The lawsuit filed by several HMO groups to stop HCFA's competitive-bidding demonstration project in Denver was heard May 16 by Judge Walker Miller in the same building as the trial of Timothy McVeigh, accused in the Oklahoma City federal building bombing.
The McVeigh trial had taken the day off, but security at the Denver federal courthouse was still very tight, according to a spokeswoman for the Colorado HMO Association, one of the plaintiffs in the case against HCFA.
"It was still pretty scary," the spokeswoman said.
Outliers is sure that the location of the trial had nothing to do with it, but the American Association of Health Plans, another plaintiff, seemed to go out of its way in a press release announcing the case to shy away from any anti-government rhetoric. "We have enjoyed a longstanding relationship with (HCFA) that has otherwise been both collaborative and productive," according to the release.
Quotable. "This has freed me to live my life as I was created to live it. Those who have known me through the years know that my life is dedicated to service."-Rena J. Blumberg, retired trustee of the former Blue Cross and Blue Shield of Ohio, after returning $662,953.17 she received when she and six other trustees retired last May. The trustees were paid for the remaining two years of their terms and given enhanced retirement benefits less than a month after approving the sale of the plan to Columbia/HCA Healthcare Corp. The sale was rejected by state insurance regulators. Blumberg is among several trustees and executives named in a policyholder lawsuit challenging such payments.
Guarded comments.Executives at Columbia/HCA Healthcare Corp. came out of their bunker and had the welcome mat out for Outliers and other media at the company's annual shareholders meeting earlier this month at the Opryland Hotel in Nashville. But the courtesy didn't exactly extend to groups protesting the company's policies.
Bomb-sniffing dogs and other heavy-duty tactics were used by some 14 private security personnel, who according to a document obtained by Outliers were told "to observe all persons approaching the protectees and anyone who appears to be unusual, agitated or behave in a bizarre manner." One security man was assigned specifically to Columbia Chairman and Chief Executive Officer Richard Scott and another to Columbia President and Chief Operating Officer David Vandewater.
Some protesters did gain entrance to the hotel, but they weren't allowed past the lobby of the conference room where the shareholders were gathered. Meanwhile, reporters were offered a luncheon presentation on company operations by Scott and a press conference after the shareholders meeting.
The protesters included regulars like the Service Employees International Union and INFACT, a Boston-based consumer watchdog group. The groups didn't have much to add to their past gripes about the healthcare giant.
Scott said he takes the protests in stride. "We've become a big company. This is part of what happens if you run a publicly owned corporation."