While the financial collapse of Allegheny Health, Education and Research Foundation has kept the expected cadre of investment bankers, journalists and grand jurors busy, it has also supplemented the career of a Philadelphia academic.
Lawton Burns, a professor of healthcare systems at the University of Pennsylvania's Wharton School of Business, first delved into AHERF when he was asked to give a speech. A year later, he has interviewed more than 15 area healthcare industry observers, made several more presentations and hired three MBA students to assist him. The work will likely culminate in a long article expected to be published in the journal Health Affairs in early 2000 along with articles in other scholarly publications. By Burns' estimates, what once appeared to be a brief diversion now takes up about 20% of his time.
"This story essentially ended Aug. 4 (with the sale of AHERF's last solvent hospitals to Western Pennsylvania Health System), but the problem is, the story keeps going on," Burns told attendees at the Integrated Healthcare 2000 conference in Aspen, Colo., last month.
Of particular interest are AHERF's intricate financial arrangements and former President and Chief Executive Officer Sherif Abdelhak's dominance of fellow AHERF executives and system trustees.
"A lot of interesting cases for teaching business students about healthcare management are going to come out of this," Burns says.
They're all buildings. Perhaps in search of novel ways to cut costs, one struggling nursing home company is looking outside the box for leadership. Way outside.
Mariner Post-Acute Network, an operator of 400 skilled-nursing facilities and 11 long-term acute-care hospitals, has hired budget hotel executive Francis "Butch" Cash as its new chairman, president and chief executive officer.
Cash, 57, filled those same posts at Hilliard, Ohio-based Red Roof Inns until it was acquired in August for $1.1 billion by Paris, France-based Accor, owner of the Motel 6 chain.
This won't be Cash's first venture into healthcare. From 1992 to 1995 Cash was president, chief operating officer and director of King of Prussia, Pa.-based NovaCare, which used to provide rehabilitation services to nursing homes and now operates outpatient rehabilitation clinics.
But the move will be quite a change for Cash, who presided over a 322-hotel network earning $34 million, or $1.24 per share, on $375.3 million in revenues in 1998.
In its most recent quarter, ended June 30, Mariner generated $487 million in revenues but posted a net loss of $405 million, or $5.51 per share. Mariner, which has sold and closed some noncore business units and laid off 7,000 employees to try to pare expenses under Medicare's new prospective payment system for skilled-nursing facilities, has been without a CEO since the June resignation of Keith Pitts.
Cash's appointment does not represent a new direction for the company, a spokeswoman said. But a new direction may be exactly what the company needs.
Changing docs' behavior. Can you teach professionalism?
Apparently so, according to the Association of American Medical Colleges, which says the nation's medical schools should expand their instruction on professionalism.
According to an AAMC survey of 116 medical schools, 10% had no curriculum in professionalism, and only half of those that did had formal methods of assessing the professional behavior of students. The study was published in the Sept. 1 issue of the Journal of the American Medical Association.
Of schools that submitted course materials for review, three of four covered ethical and moral standards. Less common was instruction in responding to societal needs, subordinating self-interest and displaying core humanistic values.
Says AAMC President Jordan Cohen, M.D.: "As the U.S. healthcare system continues to become more complex and less consumer friendly, the need to educate physicians who embody the key attributes of professionalism cannot be understated."
You can go home again. Good radiologists are hard to find. So when North Arundel Hospital in Glen Burnie, Md., needed help with computed tomography scans, X-ray films and ultrasound exams in its new emergency room, Stewart Axelbaum, M.D., called on an old friend, his retired transcriptionist, Beatrice Price.
Price's son Greg, 40, is a radiologist, who had a private practice in Delaware. As a kid, the younger Price was a fixture at the hospital, tagging along with Mom, who worked all kinds of shifts, including nights and weekends.
Evidently Price couldn't get enough of the place. During college he worked in the environmental services and pharmacy departments at 314-bed North Arundel. Would he consider coming back home, Axelbaum wondered, figuring that it couldn't hurt to ask.
"I accepted the job without hesitation," Price says.
Price, who started in July, lives in Glen Burnie, a Baltimore suburb, during the week and commutes to Delaware on the weekends. "I am very comfortable working with familiar faces that I knew as a child and who still ask me about my mother on a daily basis."
Indexing trouble spots. The Florida Agency for Health Care Administration is making like a big investment bank these days.
The agency has developed a portfolio of stock indexes to track the finances of providers doing business in Florida.
Sector-specific indexes cover publicly traded HMOs, hospitals and nursing homes. A composite Florida Health Care Index consists of 16 stocks, including Aetna, Beverly Enterprises, Columbia/HCA Healthcare Corp. and Tenet Healthcare Corp. "We needed to have a better handle on what was happening in the healthcare industry," says John Noble, director of corporate affairs for the agency.
The agency, which regulates the industries covered by the indexes, will use the data to help identify potential trouble spots before they erupt into bankruptcies or service cutbacks, Noble says. The indexes can be viewed at www.fdhc.state.fl.us/stocks.