Tag Archives: business of health care

Patient gets billed $58k for a dubious airlift

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Reporting for WCNC-Charlotte , Stuart Watson starts with a $58,477 air ambulance-related bill and works backward to determine the bewildering market forces that conspired to push a rural stroke victim’s bill into the stratosphere.

After reading or watching his story, most will agree with Watson’s assertion that “The details of Pridmore’s flight from Piedmont Medical to MUSC raise questions about whether the intense competition for patients and their health care dollars infects the decision of where patients are treated and whether they are flown to that treatment.”

The most baffling part of the whole story? That the patient in question was initially transported to a certified stroke center by ambulance, and the flight itself was only spurred by the dire proclamations of a remote doctor speaking over a webcam.

Almost as ridiculous? That the helicopter used for the flight came from 140 miles away and had to refuel en route, when there was another chopper hanging out on standby just 20 minutes from the patient. The final indignity? The patient was stuck with the bill for all these aerial shenanigans because his insurer reckons the flight wasn’t medically necessary.

Cash-strapped Ill. goes after hospitals’ nonprofit status

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

A New York Times article written by Bruce Japsen, an independent journalist writing for the Chicago News Co-Op, digs into Illinois’ recent challenges to the tax exemptions granted to a trio of prominent hospitals by virtue of their nonprofit status. The challenge, inspired in part by the state supreme court’s willingness to uphold the revocation of the nonprofit status of an Catholic hospital in Urbana last year, could expand to more than a dozen other institutions as the state scrambles to cover a looming revenue shortfall.

In its case, the state alleges that the hospitals aren’t providing a high enough proportion of charity care to fulfill the mission of a nonprofit.

All three of the hospitals the state is focusing on provided free and discounted medical care that ranged from 0.96 percent to 1.85 percent of patient-care revenue, according to the revenue department. The state also said that each one had been operating as a “for profit” business when the state’s Constitution says that “only charities are entitled to a tax exemption.”

The hospitals, for their part, point to the other benefits they provide the community, such as neonatal intensive care and burn units, that don’t always bolster their bottom lines. Advocates answer that paying taxes provides a community benefit as well, one that can readily be measured in dollars and cents. And Japsen found that paying those taxes doesn’t even seem to preclude the provision of charity care, especially at the parsimonious levels provided by the hospitals currently targeted by the state.

“The relative amounts of charity care provided by not-for-profit tax-exempts are not materially different from the amount provided by for-profit hospitals,” said Jim Unland, a longtime analyst of Illinois’ health care industry and president of the Health Capital Group, a consulting firm in Chicago. “This raises the issue of whether the tax-exempts are getting prejudicially favorable treatment.”

The three hospitals whose tax exemptions have been stripped by the state department of revenue plan to challenge the action in court, and state hospital organizations are gearing up for a lobbying push they hope will put their tax status on firmer ground.

CPI investigation details health information technology sector’s lobbying efforts

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Writing for The Center for Public Integrity’s iWatch News, Josh Israel reports that, with billions of stimulus dollars still at stake, the number of health information technology lobbyists taking advantage of the lucrative “revolving door” between Capitol Hill and the private sector is sky-high, even by D.C. standards.

The Obama administration is still working to iron out the details of the “meaningful use” mandate expressed in the recovery act, and the big players in health IT are pulling out all the stops to ensure the rules are written to their advantage.

Healthcare Informatics magazine publishes an annual ranking of the 100 largest health IT companies by annual revenue. According to the Senate Office of Public Records, 15 of the companies in the 2010 ranking — most of them ranked in the top third by revenue — reported health IT-related lobbying activity in the first quarter of 2011 or the last quarter of 2010. Of the 90 lobbyists listed as having done health IT lobbying for those firms, at least 63 were former Congressional and/or executive branch staffers, many of whom worked for health-related agencies or committees.

For those interested in additional details on HIT’s lobbying efforts, Israel also included two sidebars:

Hospital sues to block release of records

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

Parkland Memorial Hospital in Dallas, the subject of recent reports that patients were at risk, has sued the Texas attorney general in an attempt to prevent the release of records requested by The Dallas Morning News.

Brooks Egerton reports:

Parkland filed the latest lawsuit — its fifth against the AG related to the newspaper — on Monday. This time the goal is to block release of Parkland police department records dealing with the psychiatric emergency room. The News is not seeking medical records.

Related:

Reports detail Dallas hospital on brink of losing federal funds

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Late Friday, a damning federal report declaring that patients were at risk at Parkland Memorial Hospital in Dallas was released. Even later that same day, Dallas Morning News reporters Miles Moffeit, Sue Goetinck Ambrose, Reese Dunklin and Sherry Jacobsen published their first report online (available to subscribers only).

The reporters write that the inspectors’ findings were released in response to a reform plan the hospital submitted just before its Friday deadline, a plan they report “involves hiring new nurses; rewriting some policies; retraining staff; retiring outdated medicines, supplies and equipment; and launching an intensive series of daily or weekly performance audits over at least the next five months.” According to those who have viewed the 600-page release, they have a lot to overcome.

“It appears safety was routinely relegated to a lower priority by other pressures,” said Vanderbilt University professor Ranga Ramanujam, a national expert in health care safety. “The CMS action is extraordinary. I am hard-pressed to think of an example of a similarly high-profile hospital facing the very real possibility of losing their CMS funding as a result of safety violations.”

The paper’s speedy, thorough response to the release shouldn’t be entirely surprising, considering that they’ve been out ahead of the story from the very beginning.

The top-to-bottom July inspection of Parkland was sparked by a News report of the death of a Parkland psychiatric patient in February. The hospital didn’t report the death to the Texas Department of State Health Services or to CMS, both of which then investigated the case. CMS regulators later determined that the rights of the patient, George Cornell, had been violated repeatedly by Parkland.

The hospital has until Sept. 2 to get its correction plan approved by CMS and to pass inspections, otherwise it could lose the Medicare and Medicaid funds on which it so heavily depends.