What appeared two months ago to be simply a small part of a national probe of Medicare fraud in laboratory billing instead might have been an early warning of the widening investigation of Columbia/HCA Healthcare Corp.
A lone FBI agent questioned a "few" physicians at Blake Medical Center in Bradenton, Fla., on June 6 about "ordering and billing procedures for blood tests," Columbia spokeswoman Eve Hutcherson said at the time.
No documents were taken. Although the nature of the FBI's interest in the billing procedures at the Columbia facility wasn't clear, it was known at the time that federal probes into laboratory billing practices were becoming more common.
Two weeks ago, federal authorities returned to Bradenton, this time seizing loads of documents. Then, last week, three top Columbia executives were indicted on Medicare fraud charges. Jay Jarrell, chief executive officer of Columbia's southwest Florida division; Michael Neeb, the division's chief financial officer; and Robert Whiteside, its former director of reimbursement (he now holds that title at Columbia's Nashville headquarters), were named in the indictment.
Speaking of Columbia.With industry speculation rampant that Columbia may change its name as well as its tough-guy corporate image, two thoughts occur to Outliers.
One is the irony of the healthcare giant possibly dropping the Columbia moniker after it beat back a trademark infringement lawsuit in April that had been filed by Columbia-Presbyterian Medical Center in New York.
The other is a suggestion. As it still has the HCA affiliation, how about calling itself Healthcare Corporation of America? That way, the company would keep part of its brand name, while updating the former Hospital Corporation of America moniker. Stay tuned.
Who needs Wall Street?Blue Shield of California hasn't joined the chorus of its sister plans singing the not-for-profit blues.
The San Francisco-based plan hasn't been pining for the for-profit, publicly owned status that other Blues plans say they need to access the capital markets. On the contrary, Bruce Bodaken, its president and chief operating officer, says the plan has more than $400 million available for investment and is one of the fastest-growing HMOs in the state, thanks to its open-access product, the first to be offered in California.
Last week the company confirmed it will acquire Woodland Hills, Calif.-based CareAmerica Health Plans, a for-profit HMO subsidiary of UniHealth. Blue Shield will integrate CareAmerica into its not-for-profit system, thus reversing the usual order of conversions these days.
That prompts Blue Shield Chairman and Chief Executive Officer Wayne R. Moon to muse: "Since plans converting to for-profit status have to establish a foundation, do we get money from a foundation?"
Probably not. In any case, Blue Shield now will have a presence in Woodland Hills, headquarters of giant for-profit rivals WellPoint Health Networks-formed when Blue Cross of California converted-and Foundation Health Systems.
Survey hits home.A new survey has found that many seriously ill people would rather die than live permanently in a nursing home.
A report published in the July issue of the Journal of the American Geriatrics Society found that nearly one-third of seriously ill people-defined as those with such conditions as advanced lung or colon cancer-would choose death over permanent nursing home life.
Thirty percent of the 3,262 respondents to a 1995 survey would rather die than live in a nursing home. Another 37% said they would be somewhat or very unwilling to live in a nursing facility. Only 26% would be somewhat or very willing to live in a nursing home.
The study's lead authors say the findings show that doctors need to be aware that patients might not want to receive treatment that will result in permanent nursing home residency, and that researchers need to find out why so many patients would choose death over nursing homes.
The name game.It may sound generic, but a St. Paul, Minn., hospital thinks its new name reveals its new mission.
Beginning in September, 325-bed St. Paul-Ramsey Medical Center will be called Regions Hospital.
"People need to know we have quality programs that go beyond our traditional offerings," says Pat Motherway, a hospital spokesman.
For example, the once local hospital has an array of services and caters to a wide geographic area, attracting some patients from surrounding states, Motherway says. Ramsey County owned the hospital for 114 years, before it became a private not-for-profit in 1986 and then merged with HealthPartners, a Bloomington, Minn.-based HMO, in 1993.
Market research helped hatch the new name, and new stationery already is on order.
But is the new name too plain? Motherway doesn't think so: "It's a name we will be able to define for ourselves."
Quotables."I don't think we have a lot of bad doctors out there. What we have are doctors who don't know they are practicing bad medicine because nobody is tracking (the outcomes of) what they do."-Lee Newcomer, M.D., chief medical officer of Minneapolis-based United HealthCare Corp., at the recent Montgomery Dorsey Symposium in Vail, Colo.
"If I was getting away scot-free with billions of dollars, I would say `end the debate,' too."-Malik Hasan, M.D., chairman and chief executive officer of Foundation Health Systems, Woodland Hills, Calif., responding to comments made by Lawrence B. Garcia, general counsel of San Francisco-based Catholic Healthcare West at the symposium, sponsored by Denver-based Columbia-HealthOne. Garcia said he wants to end the debate over whether for-profit or not-for-profit providers are best for healthcare by focusing on what kind of services best serve the public good.
To reach Dr. Sam.Last week, Outliers was provided with the wrong phone number for Dr. Sam and the Managed Care Blues Band (July 28, p. 46). The correct number is 561-243-3673.