Some things to chew on:
* Say what you will about Columbia/HCA Healthcare Corp., but give the world's biggest hospital company credit for fighting back to solid profitability. It's only been a couple of years since Columbia limped away from the stain and carnage of the Rick Scott debacle. But in calendar 1999, Columbia earned $657 million, up 73% from a year earlier, and shed 57 of its less-desirable hospital properties in a restructuring deal.
Despite the seemingly good results, Wall Street hammered Columbia's stock following the earnings announcement because investors anticipated an even stronger performance. Go figure.
Operationswise, Thomas F. Frist Jr., M.D., Columbia's chairman and chief executive officer, faces the same Medicare cutbacks and increased drug costs that other hospital managers do, but he appears to have his troops well-focused on efficiencies. The latest initiative will consolidate back-office functions and squeeze costs out of the supply chain.
The next big hurdle is reaching a settlement with the government on its long-winded Medicare fraud investigation of Columbia. Then, the company should seriously consider going back to calling itself Hospital Corporation of America.
* David Shulkin, M.D., and his team at DoctorQuality.com gave up promising careers at prestigious health systems to venture into the risky Internet world. Bless their hearts and pass the venture capital bucks.
But readers of Scott Hensley's insightful Feb. 21 cover story on DoctorQuality should feel a pang of regret at Shulkin's frustration with healthcare providers' lack of results in quality improvement.
"We thought that would happen from within," Shulkin said. "I made a 10-year bet that it would be providers who made the difference. But I was wrong."
Consider that a supreme challenge to those health system physicians and managers still determined to improve quality of care from within.
* If President Clinton wants to ride out of the White House on a white horse leading the charge for a prescription drug benefit for Medicare beneficiaries, he shouldn't do it at the expense of healthcare providers. His proposal to reduce budgeted Medicare payments to providers by $19 billion over five years to help fund the $28.8 billion drug benefit is misguided. Although some analysts believe the president is posturing on cuts, it's annoying that he still views hospitals as a personal piggy bank.