As New York State slogs into the fourth month of fiscal 2000 without a budget, a powerful labor union and a regional hospital association are slinging mud over how to win Medicaid concessions and break the logjam in Albany.
The verbal jousting match was set off by a series of television ads lambasting Gov. George Pataki's plan to lop billions out of Medicaid and warning that without relief hospitals will close. The multimillion-dollar media blitz is backed by the powerful National Health and Human Service Employees Union Local 1199 and its outspoken leader, Dennis Rivera.
"We make no bones about it, we are rallying to avert the cuts," says Ken Sunshine, a spokesman for the union. He readily admits that saving jobs is a major part of the union's agenda.
Rivera's ads, appearing in markets throughout the state, struck a tender nerve with hospital executives in upstate New York, who don't always see eye to eye with their Big Apple colleagues. "We're not swimming in the dough, but we didn't like the tone of the ads from the beginning," says Gary Fitzgerald, executive director of the 58-member Iroquois Healthcare Alliance, based in Clifton Park, N.Y.
After fielding calls from patients and community leaders, the upstate chief executive officers had Fitzgerald fire off a press release calling on Local 1199 to put a lid on the rhetoric and dump the ads.
Rivera's well-oiled lobbying machine has no intention of pulling the plug and claims to be shocked by the Iroquois counterattack. "It's clear that they were just doing Pataki's bidding," Sunshine says.
Fitzgerald denies the allegation. "We just thought it was time to stop the name-calling and put together a budget for the next 12 months."
Desperately seeking compliance. Big medical groups are starting to pay attention to corporate compliance, although it's not easy to get physicians and executives to understand the importance of properly documenting billable services, according to lawyers who spoke at the annual meeting of the American Medical Group Association in San Francisco last month.
"It amazes me that even today there are a lot of organizations out there that haven't even addressed corporate compliance," says Frank Anderson, director of corporate compliance at Scott and White Clinic in Temple, Texas.
Kathy Kenyon, general counsel at Deaconess Billings (Mont.) Clinic, says large groups make convenient targets for federal fraud detectors. She advised groups to heed the complaints of their patient accounts staff and imagine what the staff might tell a U.S. attorney.
Another creative strategy came from the Marshfield (Wis.) Clinic, according to its staff attorney, Marla Fisher. To encourage documentation, the clinic has begun levying its doctors a $5 fine each time they fail to submit charges within five days of a patient visit.
Discovery zone. When Fargo, N.D.-based Lutheran Health Systems and Phoenix-based Samaritan Health System complete their merger at the end of August, the new system will have a new name: Discovery Health System.
The name was picked because "Discovery is a metaphor for the future direction of the new company," says Samaritan spokesman Dan Green. "We hope to discover better ways to serve the community, to make employees thrive and find ways to make the merged company grow."
The corporate logo for the merged system will be a "highly stylized, metaphorical compass," Green says.
Discovery's corporate headquarters will be in Fargo, although there will be a subsidiary called Discovery Health Arizona in Phoenix.
Healing notes. Stanford University Hospital in Palo Alto, Calif., has an official troubadour.
Not content, as many hospitals are, merely to have a music and arts department, the teaching hospital is experimenting with bringing the healing powers of Latin American music directly to patients' bedsides.
Homero Oyarce, a 44-year-old guitarist and singer, is paid by the hospital to wander its halls, repeating his soothing ritual, a repertoire of traditional songs such as "Guantanamera."
Maryann Boeger, a dance teacher and marketing specialist hospitalized for several weeks with a serious colon condition, says Oyarce "brings me relief. I don't have to think about what I'm doing here."
"We get a lot of (positive) feedback and anecdotes. We know it works," says Judith Fields, the former head of the music program at the hospital.
Two decades ago, Oyarce was hospitalized for several months in Peru after a serious bus accident. "When I recovered, I told the doctor I wanted to come back to the hospital to sing to the patients, and he told me that a hospital was a serious place where that could not be done," he says.
Now, in a far different place, he has his chance. Oyarce remembers one time when a young doctor grabbed his arm and took him to a patient who was shaking with convulsions. "I started playing and the young man focused his eyes to the guitar. I don't want to say it was a miracle, but he calmed himself."
On the road again. When healthcare executives at public companies need cash, they go on a "road show" to raise money from investors nationwide.
One nursing home administrator is going on his own road show in the hope of raising funds to build a chapel for residents.
Carl Baker, administrator at King-Bruwaert House in Burr Ridge, Ill., is riding his bicycle for 30 days to raise $100,000 for the chapel. He plans to begin the trip Aug. 25, tracing 2,300 miles of historic Route 66 from Santa Monica, Calif., to the driveway of the nursing home.
It's the second such fund-raising trip for Baker, who in 1996 rode from the nursing home to Atlantic City, N.J., to raise money for a greenhouse, which finally opened this year.
Says Baker: "I'm willing to sacrifice my body for any amount of money I can raise."