Eight in 10 free-standing hospitals surveyed said they didn't routinely prepare for turnover among midlevel and top leadership, according to a survey by the American College of Healthcare Executives. Larger hospitals and those with older chief executive officers were more likely to have chosen a successor for their CEO. One-fourth of free-standing hospitals without a named CEO successor reported not having internal candidates, and 46% said selecting a successor was not a high priority. Transition planning is important because it helps maintain smooth relations among management, doctors, professional employees and the community, ACHE President and CEO Tom Dolan said. Of 158 hospitals that responded to a question on the importance of ethnic diversity in assembling a short list of candidates, 9% said it was "considered mandatory," while 87% said it was not important. Nearly 720 free-standing hospitals replied to the mail-in poll. The survey was conducted by a Rush University professor and executive search firm Tyler & Co.
A new quirk in quality
Previous studies have suggested that academic medical centers are the best choice quality-wise for patients over age 65 and for those needing tertiary care such as major cardiac surgery, but a new study said younger patients may get the same quality of secondary care at a much lower price from community hospitals. Secondary care refers to lower complexity procedures, such as normal deliveries and orthopedic surgery. Researchers tracked seven inpatient complications, including mortality, for secondary care at community and teaching hospitals in six states. In three of the outcomes-mortality, wound infection and urinary tract infection-community hospitals outperformed teaching hospitals. Teaching hospitals had better results for two outcomes, pneumonia after major surgery and pulmonary compromise after surgery. Meanwhile, inpatient costs per case at academic medical centers were 19% higher than at community hospitals, the study said. The study was commissioned by the Pioneer Institute for Public Policy Research, Boston. Researchers concluded that academic medical centers could lose much of the under-65, privately insured, secondary-care market if consumer-driven health plans grow in popularity and if consumers respond to their financial incentives.
California sues insurers
California Insurance Commissioner John Garamendi sued health insurer Cigna Corp. and three life and disability insurers for allegedly taking part in an illegal kickback scheme. The lawsuit in San Diego Superior Court is among a growing number nationwide involving the insurance industry's broker-commission practices that were touched off earlier this year by an investigation by New York Attorney General Eliot Spitzer. Garamendi contends that the insurers paid employee-benefits broker Universal Life Resources millions of dollars in secret commissions and other fees in return for steering business their way. The suit seeks to stop the alleged practices and freeze "ill-gotten monies" in a trust. The other defendants are MetLife, Prudential Financial and UnumProvident Corp.