In New York's trendy SoHo district, Columbia/HCA Healthcare Corp.'s deepening troubles over a billing fraud investigation have risen from the pages of newspapers and magazines to become conceptual art.
Plastered on boarded-up storefronts and scaffolds in the neighborhood are 11-by-17 inch black-and-white posters featuring the likeness of Chairman and Chief Executive Officer Thomas F. Frist Jr. Beneath a two-inch headline reading "An Open Apology" is a homespun letter credited to Frist, but obviously the work of a satirist.
Starting with syrupy mea culpas, the letter mawkishly appeals for passersby to forgive and forget, sort of.
"Believe me-not as CEO of the nation's largest for-profit healthcare provider but as a friend-it takes more than patients (get it?) to maintain high earnings and growth. It takes you, friend! Mind you, a new day is dawning. A day in which our relationship with you, friend, grows beyond the pettiness of name-calling, lawsuits and search warrants. A relationship that will revolutionize healthcare."
To stoke that friendship, the letter promises 20 free minutes of time on an AT&T calling card in return for each patient referral to Columbia, then ends with the salutation "Sincerely, your friend, Thomas `Big Tommy' Frist."
The work is cryptically credited to "N public works corporate apologist series." Evidently, "N" prefers to let his or her art do the talking. Outliers couldn't find a telephone listing, Internet posting or other evidence of the artist's identity.
Foreign mirror.Reports of false claims made by a hospital system to get larger government reimbursement. Arrest warrants served against a veteran healthcare official. No, it's not Nashville, it's Osaka, Japan.
Local prosecutors served arrest warrants last week to the head of an Osaka hospital and three others on suspicion of acquiring some 51 million yen in public money through false claims.
Charged were Mototaka Yasuda, the 77-year-old head of Yasuda Hospital Group; Saburo Konishi, 67, chief manager; Ichiro Yamaguchi, 56, manager; and Emiko Omura, 49, chief nurse.
They are suspected of having presented false reports overstating the number of their employees to take 4,240 yen per patient in extra medical subsidies from the Osaka municipal government between January 1996 and February 1997 and of swindling the government of some 36 million yen in nursing subsidies in 1995 for patients eligible for public relief.
Not-for-profit, but looking good.Who says profitmaking and market domination are only for money-grubbing Wall Street titans? Not Standard & Poor's Corp.'s CreditWeek Municipal, which finds the number of AA+ not-for-profit healthcare credits has tripled in the past 12 months.
In a feature report, the New York-based credit-rating agency predicts more healthcare upgrades to AA+-the top rating for uninsured debt-and more positive outlooks. Industry trends and strong investment returns are enabling premier healthcare credits to grow even stronger, it says.
Standard & Poor's stable of top-tier credits includes:
Mayo Foundation, Rochester, Minn., lauded for its "sterling reputation, geographic diversification, and national and international business draw." Mayo posted a $75.9 million profit on revenues of $2.4 billion in 1996.
Evanston (Ill.) Hospital Corp., which maintains a liquidity fund with reserves that equal its outstanding debt. The hospital had 838 days' cash on hand and an 18.5% profit margin in 1996.
Sisters of Mercy Health System, St. Louis, whose recent upgrade "reflects business strength across multiple markets combined with an exceptionally strong financial profile." The system's ratio of cash to debt stands at an impressive 238%.
Fanning the flames.Officials at MetroHealth System in Cleveland were floored when a recent billing dispute with a Medicaid HMO escalated into charges of racism.
It started when the Cuyahoga County-owned system sued Total Health Care Plan for more than $2 million in alleged unpaid bills. MetroHealth also canceled its contract with Cleveland-based Total Health, which claims about 30,000 enrollees.
A few weeks later, the minority-owned plan issued a statement that seemed to suggest a racist motive on MetroHealth's part. It said MetroHealth's actions suggest it is allied with another Medicaid HMO.
"It is by no coincidence that Metro has targeted a minority-operated HMO to facilitate their alliance," the statement said.
It added: "Perhaps the actions and allegations made by MetroHealth originate from their lack of desire to serve the Medicaid recipients of the community."
That's a major charge to levy against the state's largest Medicaid provider, which MetroHealth says it is.
"It's totally preposterous," said MetroHealth spokesman Jim Gosky. "I think my boss called it `very sad."'
Help! An Oryx!It's a daunting prospect for any hospital: Choosing the right information system and vendor to meet the Joint Commission on Accreditation of Healthcare Organizations' new requirements for quality improvement, dubbed Oryx. As of this writing, the commission has certified 99 vendor products for submitting quality data. Our head is spinning.
But wait! Here comes a software vendor to help you choose your software vendor. On-Line Consultant Software of Roseville, Calif., is offering "Oryx Selector." It includes a performance measure inventory, performance improvement priorities, measurement goals, a project schedule and a project team roster. For those hospitals grumbling under their breath about how much Oryx is running up the bill, the company also includes a "cost evaluation tool." To get details, see the World Wide Web site at http: www.help4oryx.com.
Comments the JCAHO's Jarod Loeb, who heads up evaluation of measurement systems for the Oryx project: "There may be lots of animals out there, but there is only one Oryx." Amen to that!