DETROIT-Henry Ford Health System and Farmington, Hills, Mich.-based Mercy Health Services have signed an agreement to collaborate on a delivery system in suburban Oakland County, Mich. Henry Ford's 160 physicians in Oakland County will be able to admit more patients close to home, at St. Joseph Mercy Hospital in Pontiac, said Linda Messina, a Henry Ford regional administrator. In the past, more than 4,000 Oakland County patients have been admitted annually at Henry Ford Hospital in Detroit, but it's not known what proportion will shift to St. Joseph, said Michael Slubowski, Mercy's director of operations for Michigan. St. Joseph also may pick up long-term, ambulatory and home-care patients, Slubowski said. Mercy's 375 network physicians in Oakland County will gain admitting privileges at Ford facilities. Collaboration could extend to developing centers of excellence at St. Joseph in oncology, orthopedics and athletic medicine and reciprocal participation of physicians in each system's health plans.
CHICAGO-Rush-Presbyterian-St. Luke's Medical Center scored a victory in court last month. A judge in U.S. District Court in Chicago ruled it was "unlawful" for HHS to use 1984 physician compensation limits when figuring 1988 Medicare cost reimbursements for the 816-bed hospital. Rush argued that HHS was required to update its reasonable compensation equivalents limits annually. The case ended up in court because HHS denied reimbursement requests from Rush that adjusted for an increase in physician salaries above the 1984 limits. HHS officials would not comment on the pending litigation, but hospital attorneys expect an appeal.
ST. LOUIS-RightChoice Managed Care, the for-profit subsidiary of Blue Cross and Blue Shield of Missouri, has sued the state employee health plan, alleging its actions and policies have materially injured the insurer. About 26,000 state employees, retirees and dependents are enrolled in two of its insurance products, BlueChoice HMO and HealthNet Blue. RightChoice says the Missouri Consolidated Health Care Plan exceeded its statutory authority by including other public organizations in the plan without conducting proper actuarial analysis. RightChoice seeks $18 million for estimated losses in plan years 1997 and 1998.