A mid-1990s fad of physician-owned health plans resulted in many financial flops. Yet a group of consultants is still trying to sell doctors on the idea of owning their own plans.
De Marco and Associates, which bills itself as an independent consulting firm based in Rockford, Ill., recently announced a seminar on how physicians can eliminate the managed-care middleman by starting their own health plans or doing direct contracting with employers. The seminar, to be held twice this fall, in Valencia, Calif., and Hilton Head, S.C., is based on a book, Physician Driven Health Plans, Innovative Strategies for Restoring Physician-Community Integration.
One of the presenters, Orlando, Fla.-based consultant Michael Barrett, acknowledges that physician-owned health plans are risky. But he says physicians' not exploring their options is "at least as risky."
"I have in my hand a list..." Sen. James Inhofe (R-Okla.) seems to be taking a page from the playbook of the rabidly anti-communist Sen. Joseph McCarthy in the continuing fight to dismantle the Balanced Budget Act of 1997.
Inhofe, who isn't on a Senate committee with authority over healthcare issues, says the Medicare payment restraints imposed under the budget law could result in the closure of 23 Oklahoma hospitals, the Associated Press reported.
He would not name them, however; and neither would the Oklahoma Hospital Association, with whom Inhofe is hosting a forum Aug. 31 at St. John Medical Center in Tulsa, Okla.
In announcing the forum, his rhetoric sounds vaguely familiar and wouldn't seem out of place in an American Hospital Association press release.
"The reductions in Medicare reimbursements required by the Balanced Budget Act have placed severe strains on our hospitals and have come at the expense of healthcare to many in Oklahoma," Inhofe says. "If this situation is not resolved soon, the quality of healthcare options in Oklahoma will be in jeopardy."
Oops. He forgot to mention his vote in favor of the 1997 budget law.
A bill by any other name... Is it Dingwood, Dingellwood or Dorwood? That's the question of the month for the lobbyists in the managed-care reform battle as they while away the lazy August congressional recess.
The monikers, of course, refer to the managed-care bill drafted by dissident Republican Rep. Charlie Norwood (R-Ga.), a dentist, and the liberal lion, Rep. John Dingell (D-Mich.).
A composite of the two names, "Dingellwood" is the name most frequently used by managed-care lobbyists, although "Dorwood" has its own following.
To be fair, however, to another lead sponsor, Rep. Greg Ganske (R-Iowa), a surgeon-who has done more than his fair share to anger the GOP leadership-they might consider calling it "Dorwoodske."
But ask a pro-regulation lobbyist what he calls the bill, and you get a different answer. "We're trying to be more respectful of our two leaders-it's Mr. Norwood and Mr. Dingell," says Ron Pollack, executive director of Families USA, a healthcare consumers group.
Soft beneath the crust. No one remembers a wrinkle on Jean Akehurst's nursing uniform at Johns Hopkins Hospital, Baltimore, nor a time when she stepped outside her starchy demeanor as a head nurse on the evening shift.
But after she died at 79 last fall, she surprised colleagues by donating $1.2 million to the institution.
"I don't think she showed much affection to anyone, and I don't think she showed it in nursing," says Anna Flatley, a fellow nurse who knew Akehurst for 58 years. "But she must have had a generous heart after all."
Hopkins' treasurer, Thomas Trzcinski, says the sizable donation would be common from a trustee but is one of the largest ever from a line worker. During the past five years, about 10 other retired nurses donated amounts of at least $250,000 each.
Akehurst graduated from nursing school in 1943 and worked until fracturing her hip on duty in 1983. Her husband, firefighter Ernest Akehurst Jr., died in 1978, and she was estranged from a sister.
In her final years, the chain-smoker suffered asthma and throat cancer. She once confided to a hospital staffer the reason for her intention to donate.
"Hopkins is my family," she said.
Taking few prisoners. Minnesota prisoners have jumped on the anti-managed-care bandwagon, even if they can't ride it very far.
Since the state decided to pay $9.4 million to contract with St. Louis-based Correctional Medical Services, the number of complaints from inmates concerning medical care has almost doubled. Nearly 200 complaints have come in during the past year, compared with 118 the previous year, says Pat Seleen, the ombudsman for the prison system.
Inmates and healthcare providers argue that the quality of care has deteriorated. Company and state officials note that costs to the state have gone down by $1.72 million in the year since Minnesota signed on with for-profit CMS.
But the increase in complaints led Corrections Department Commissioner Sheryl Ramstad Hvass to appoint a citizens' panel to review prison healthcare. Recommendations are due by mid-August.
Nan Schroeder, director of medical services for the corrections department, says the shift to managed care was needed to curb rising healthcare costs. Through much of the decade, prison care costs rose by 14% every two years, she says. CMS controls roughly 45% of the $1 billion prison healthcare market, caring for one in six inmates in the U.S.
