"You don't pay the rack rate in hotels or hospitals anymore," says Milt Camhi, director of Contra Costa Health Plan in Martinez, Calif., midway through signing his name on a $155,000 check.
That was the bad part; the good part was that the bill had been discounted from $380,000.
Here's the story, or at least the outline of the story: A patient in Contra Costa's Medicaid HMO needed an organ transplant (Camhi didn't know what kind). The health plan sent him to a transplant facility in a well-known medical center (which he wouldn't name).
"We had a mutually agreed-upon 50% discount before the procedure. I didn't know how big the bill was going to get," Camhi says.
When the bill arrived, it showed the patient had been hospitalized 60 days, half of that in intensive care. Lab costs alone were $38,000. Then the patient died.
The hospital sent Camhi the bill in the middle of June, with a note. "They said, `If you give us a check in our hands by close of business tomorrow, we'll give you another 10% off the bill.' When you're starting off with $380,000, what's another 10% among friends?" Camhi says.
So he rammed the check through the business office. "Welcome to modern healthcare. It's the Wild West," he says.
Camhi doesn't begrudge the medical center its money. "That transplant center needs to be there," he says. "Hopefully we'll have a better outcome next time."
Hand wringing over hand washing. With all the major problems in medicine today, you'd think the membership of the American Medical Association wouldn't have time to consider such things as what Americans do in their bathrooms. You'd be wrong.
Here are a few offbeat items from the more than 180 resolutions that were scheduled to be voted on by the AMA's House of Delegates at its meeting last week in Chicago:
That the AMA urge the public to adopt hand washing as an important personal priority.
That the AMA recommend that at least one window in each car may be opened manually.
That the AMA endorse the concept of a protective barrier between athletes and attendees at sporting events.
That the AMA seek legislation that would make distribution of cigarettes with other products illegal.
Mind game.Brainpower provides the current that turns the gears at healthcare information system companies, and some are getting edgy about watching cerebral assets leave the building.
Industry giant Shared Medical Systems is suing rival Eclipsys Corp., charging that it lured away seven computer programmers from SMS in hopes of acquiring some of its trade secrets.
Eclipsys' chief executive officer, Harvey Wilson, founded SMS back in 1969 along with James Macaleer. SMS last year sued to keep Wilson from hiring Macaleer's brother, Terry, an SMS alumnus, who ultimately was enjoined from revealing trade secrets but wasn't prevented from joining Eclipsys.
Eclipsys spokeswoman Stephanie Massengill says Wilson developed a loyal following in the healthcare information field before departing SMS about a dozen years ago, and now he's attracting people anew with his re-entry into healthcare.
Wilson started a company to market innovative systems developed at Boston's Brigham and Women's Hospital, and that company merged in January with the healthcare division of Alltel Information Services to form Eclipsys.
Massengill says the programmers from SMS were hired for their experience with a computer language underlying much of the Brigham software, which will help produce new software that co-exists with Alltel's TDS line of systems. It's a different programming language than the one being used for much of SMS' latest work, she says.
And it's probably just coincidence that Eclipsys opened a branch office across the street from SMS' headquarters in Malvern, Pa.
Geek honor roll.Meanwhile, several healthcare companies made this year's list of the 100 best workplaces for computer professionals, an elite ranking of employment environments by Computerworld magazine that looks for low turnover, an emphasis on training, diversity in staffing and opportunities for growth. Fifteen industries were included in the competition.
Universal Health Services, King of Prussia, Pa., ranked 14th overall, ahead of such companies as Sears, Roebuck and Co., Compaq Computer Corp. and McDonald's Corp. Sharing honors with Universal Health were United HealthCare Corp., Minneapolis, ranked 31st, and Integrated Health Services, Owings Mills, Md., ranked 36th.
The name game.Artesian? No Agnesian. That's right, Agnesian.
A Fond du Lac, Wis.-based system decided to capitalize on the name recognition of its flagship, 161-bed St. Agnes Hospital, by adopting Agnesian HealthCare as its new name. It decided to drop its first name, Genesys HealthCare, after learning a Milwaukee firm was using a similar moniker.
But Outliers still can't figure out how Agnesian HealthCare "best reflects our mission to care for all in need-not just our patients, but everyone within our community," as the press release says.
As names go, it could be worse. Blue Cross and Blue Shield of Iowa actually considered naming its corporate parent Centragon. Executives decided pretty quick that Centragon might not be an improvement over the previous corporate name, IASD Health Services Corp., which stuck after the merger of the Iowa and South Dakota Blues. They finally hit upon Wellmark as a nice blend of wellness and benchmark. A May branding campaign put the Wellmark name on all the Iowa Blues companies.