Open displays of emotion are rare in Washington and are especially frowned upon when they are directed at members of Congress. But last week there were two exceptions to the rule.
The House Ways and Means Committee was debating the thorny issue of whether investor-owned hospitals should be compensated by Medicare for taxes paid.
Hospital groups have been divided over the issue for years, and furious lobbying was going on during the debate (at one point a hospital lobbyist was shooed off the members' dais) and behind the scenes (even nuns were calling members on behalf of the Catholic Health Association). With only Ways and Means Committee Chairman Bill Archer (R-Texas) left to vote, the committee was deadlocked on the measure at 19-19. After a pause, Archer voted against the investor-owned hospitals, which elicited a loud, collective gasp from the audience.
The second example occurred during the House Commerce health and environment subcommittee deliberations over the fate of the "Boren amendment," which requires states to reimburse providers "at reasonable and adequate" rates for their costs under Medicaid.
The GOP budget included a provision to kill the Boren amendment. New Jersey Democrat Frank Pallone Jr. offered an amendment to restore the measure. As Republicans took turns voting "no" on the amendment, Rep. Joe Barton (R-Texas) voted aye, as did two other Republicans. All three did so against the wishes of GOP leaders.
When it became apparent the amendment would pass without his support, Barton switched his vote to nay. The audience, which was dominated by provider and nursing home groups, booed.
Wisdom from on high.Premier alliance hosted a confab of more than 100 of its member hospitals' chief executives in Aspen, Colo., earlier this month to learn the management secrets of five of the industry's heaviest hitters.
Headlining the event was General Electric's widely admired chairman and chief executive officer, John "Jack" Welch, who explained how to create and manage change. Other CEO stars included Ralph Larsen, Johnson & Johnson; Vernon R. Loucks, Baxter International; Gerhard Moeller, Boehringer Mannheim; and Raymond Gilmartin, Merck & Co.
With turnover among hospital executives one of the few constants in healthcare, Gilmartin's task of how to make a mark as a new CEO was particularly apt. A former management consultant, Gilmartin was plucked three years ago from his job as chief executive of medical-surgical maker Becton Dickinson & Co. to run drug mammoth Merck.
His No. 1 tip: Listen to the little people. "I wanted the kind of information people normally talk about in hallways in groups of two or three, not in larger groups in the conference rooms." As Gilmartin said he had told CEOs hungry for strategic gems during his consulting career: "Your organization already knows these things. What they're afraid of is that you don't know them."
Touch, but don't reach out.A Chicago-based start-up Medicaid managed-care plan has a novel solution to keeping in touch with its often hard-to-reach enrollees: free voice mail.
Up to 30% of Medicaid beneficiaries don't have phones, says Frederick Fey, president and chief executive officer of Quantum Management Group, a managed-care development firm based in Ponte Vedra Beach, Fla. That's why plans often stumble delivering preventive care to their enrollees, who may not receive reminders for routine matters such as immunizations and Pap smears.
Fey says Family First, a joint venture of Quantum and University of Chicago Hospitals, is the first plan to deploy voice mail as a solution. Each household in Family First gets a voice mailbox on the plan's telephone system, a private identification number to access it and cards with their number to distribute to friends. The box has to be used for personal calls or there's no guarantee beneficiaries will check it for messages from the plan, Fey says.
Initially, Family First's proposal drew a special review from HCFA and the Illinois Department of Public Aid. After scrutiny, the regulators essentially said, "Fine, reach out and touch someone, just don't you dare market it." The state doesn't want voice mail to become an incentive for people to join the plan, says Nelly Ryan, chief of the public aid department's managed-care bureau.
At a fixed cost of $125,000 for the computer technology, the voice mail system seems likely to bring a quick payback, Fey says. Family First, a prepaid plan, has about 2,700 enrollees.
Set for study.Wayne Ruga, major domo of the Center for Health Design in Martinez, Calif., is Harvard-bound.
Ruga will spend the 1997-98 academic year as a Loeb Fellow at the Harvard Graduate School of Design. The Loeb program encourages independent study, and Ruga plans to focus on building stronger ties among designers, architects, healthcare professionals and patient advocacy groups.
The Center for Health Design funds research, consults with the Joint Commission on Accreditation of Healthcare Organizations and sponsors the Symposium on Healthcare Design. The 10th annual event will be held Nov. 20-23 in San Diego.
On the air.Richard Scrushy, chairman and chief executive officer of HealthSouth Corp., becomes a TV star of sorts this summer.
Scrushy has rented 60 seconds of space on a 30-minute infomercial for the Arthritis Foundation, reports our sister publication, Advertising Age. The infomercial will air from July through October on the Learning Channel, the Nostalgia Channel, other cable stations and local stations. Other sponsors of the infomercial, designed to sell publications and resource guides and videotapes for arthritis sufferers, are Johnson & Johnson's Tylenol and MCI Communications.
Quotable."If you stick to your mission, God will give you more market power."-Princeton University economist Uwe Reinhardt, exhorting Catholic hospital executives to preserve their institutions' identities. He spoke last week in Chicago at the annual Catholic Health Association conference.