About 85% of 252 healthcare experts polled for the Commonwealth Fund said the federal government should fund healthcare coverage for all uninsured people earning less than 150% of the poverty level. In addition, 77% said the government should cover Medicare premiums and other cost-sharing expenses for seniors below 135% of the poverty level. The same percentage said Medicaid and the State Children's Health Insurance Program should adopt pay-for-performance incentives for providers and health plans. And some 73% of respondents said employers that don't offer health coverage should contribute to a pool to fund Medicaid and SCHIP expansions. Harris Interactive conducted the online poll, the fifth of six on healthcare experts' policy views.
Hospitals add workers nationally
Hospitals added 10,400 workers in September, bringing national hospital employment to just over 4.4 million people, according to the Bureau of Labor Statistics' preliminary seasonally adjusted figures. Over the 12 months ended in September, hospital employment rose a total of 97,600 people, or 2.3%. Physician offices, meanwhile, added 5,200 workers in September for a total of about 2.1 million people. Over the same 12 months, employment by physician offices grew 73,200, or 3.5%. Excluding farm workers, total U.S. employment fell 35,000 in September to 134 million people, which includes job losses caused by Hurricane Katrina.
S&P predicts more downgrades
Financially distressed not-for-profit hospitals will continue to face challenges and see a disproportionate share of credit downgrades in 2006, according to ratings agency Standard & Poor's. And those hospitals will find it even more difficult to bounce back in 2007, when S&P said it expects a more challenging environment for hospitals in general. Medians for the 50 hospital organizations with speculative-grade ratings from S&P showed limited improvement in 2005. Overall, those organizations were not able to take advantage of the favorable revenue and volume trends that have helped hospital organizations with investment-grade credits, S&P said. Each organization has unique reasons for its bleak financial picture, but demographics, small size, limited business position and competition often play a role, the ratings agency said. Hospitals with speculative-grade ratings have limited access to capital despite frequent significant capital needs, S&P said.
Wash. hospital fixes problems
An investigation into patient-safety issues at Yakima (Wash.) Regional Medical and Cardiac Center ended without the state taking action against the 207-bed hospital. State health department officials said the hospital corrected all 16 deficiencies identified in a June inspection that was triggered by the resignation of the hospital's eight emergency-room physicians who cited patient-safety issues. Thirteen deficiencies involved the laboratory. Last week, Yakima Regional's parent, Health Management Associates, Naples, Fla., named a new chief executive officer for the hospital-Jay Finnegan, formerly CEO of Central Mississippi Medical Center, Jackson-and transferred former CEO Tim Trottier to a hospital in Mississippi. At deadline, the name of the hospital was unavailable. Trottier was the subject of a no-confidence vote in July by the group representing Yakima Regional's medical staff.
Mass. project needs CMS' OK
Massachusetts can't touch up to $385 million in federal Medicaid matching funds for a demonstration project to help the uninsured until the CMS approves the state's plan for funding the program. The CMS, in a letter to the Massachusetts Department of Public Health, asked to see the plan by Jan. 15, 2006. Gov. Mitt Romney has said he hopes to extend coverage to 500,000 uninsured through the Medicaid waiver program, which expires June 30, 2008. The program requires the state Legislature's approval.
Charity-care policy for Calif. system
Five-hospital Daughters of Charity Health System, Los Altos Hills, Calif., became the latest hospital system to announce a new charity-care policy establishing discounts for the uninsured amid recent debate over not-for-profit providers' handling of the uninsured. The system's board approved the new seven-page policy after a year of discussions, President and Chief Executive Officer Bain Farris said. Daughters of Charity, which split from Catholic Healthcare West in 2002, was not among the many health systems nationwide targeted in a series of class-action lawsuits over billing of the uninsured. Under Daughters of Charity's new policy, uninsured patients earning up to twice the federal poverty level will receive care at no charge, and those earning up to 400% of the poverty level will receive discounts on a sliding scale. All other uninsured patients will be charged managed-care rates, with 10% discounts for payment in full within 30 days. The policy says the system will provide care-regardless of ability to pay-without delay, limitations or pending financial discount determination. It also says the system will not take legal action for nonpayment if the primary wage earner is unemployed, uninsured or without significant income or assets.
Fla. hospital plans 200-bed tower
Shands HealthCare, Gainesville, Fla., announced plans for a new 200-bed tower for its 570-bed cancer hospital on the University of Florida Gainesville campus. Philanthropy will cover 15% to 20% of the $250 million to $300 million cost; the remaining financing will be a 30-year bond issue, Shands said. Construction is expected to begin in August 2006. The tower is not subject to state certificate-of-need review because it is an expansion, Shands said.