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John Kelly, MD, formerly the director of the American Medical Association’s quality division, has been named to head Aetna US Healthcare’s new physician relations unit.
Terry Shaw has been named as chief financial officer at Adventist Health System. Most recently he served as senior vice president and CFO at the 1,382-bed Florida Hospital in Orlando. He replaces Calvin Wiese, who will now serve as vice president of strategic development.
Sloan-Kettering Cancer Center in New York City has a new president and CEO: Harold Varmus, MD. A Nobel Prize-winner, he was most recently the director of the National Institutes of Health in Bethesda, MD. He succeeds Paul Marks, MD, who had already announced his retirement.
Matria Healthcare Inc. of Marietta, GA, has hired George Dunaway as its chief financial officer and vice president. He fills the position left by Donald Millard who will stay on as CEO.
Carlsbad, CA-based Sunrise Medical has announced that its chairman, president, and CEO, Richard Chandler, will resign. His successor is Murray Hutchison who has served as a director for the company since 1983.
Tenet Healthcare has announced the sale of two of its facilities. Palestine, TX-based Trinity Valley Medical Center, a 150-bed facility, and the 101-bed Minden (LA) Medical Center were both sold to Province Healthcare of Brentwood, TN, for $77 million.
Memorial Hermann Healthcare System has been in an acquiring frame of mind, in Texas at least. It recently acquired the 65-bed Fort Bend (TX) Medical Center from Columbia/HCA Healthcare along with the 72-bed Katy (TX) Medical Center. In exchange, Columbia received the 173-bed Memorial Hermann Pasadena (TX) Hospital and an undisclosed sum of cash.
Triad Hospitals, a division of Columbia, meanwhile sold its Beaumont (TX) Regional Medical Center (364-bed facility) and the assets of the closed Silsbee (TX) Hospital for an undisclosed sum.
UPMC Health System in Pittsburgh and Oil City, PA-based Northwest Health System have announced their intent to merge. Under the terms of the agreement, the UPMC would pay $7 million to the latter’s medical foundation as well as construct a 110-bed to 150-bed hospital sometime within the next three years and at a cost of $45 million.
NovaCare in King of Prussia, PA, will sell its 623 outpatient physical and occupational therapy clinics in 31 states to Select Medical in Mechanicsburg, PA, for $155 million in cash and the assumption of $45 million in debt. Select runs 120 outpatient rehab clinics and 44 long-term acute care hospitals in the United States and Canada.
Nashville-based Vanguard Health Systems has announced its intention to purchase MacNeal Hospital, a not-for-profit facility in Berwyn, IL, for an undisclosed sum. The sale is expected to be finalized by January 2000.
Health care plan premiums are expected to rise an estimated 10.6% next year in response to a probable increase in medical costs of 8.6%, according to a survey of more than 140 health plans by Sherlock Co., a health care consulting firm.
In comparison, this year’s premium hike is 8%. This may sound dire; however, the consulting company pointed out that health care plans had, in past years, overestimated the cost increase.
Fee-for-service health insurance plans leave their enrollees with a greater sense of satisfaction than that experienced by enrollees of managed care plans, according to a study conducted by the Employee Benefit Research Institute. The survey found that while 64% of enrollees reported being extremely or very satisfied with their fee-for-service plans, only 49% of those enrolled in preferred provider organizations and 35% of those in HMOs expressed the same sentiments.
Over the three years ending June 30, 1998, about a quarter of acute care facilities in Pennsylvania have lost money. The results were published by the Pennsylvania Health Care Cost Containment Council after examining and auditing 199 such facilities. Although the average Pennsylvania hospital made money, the average total profit margin was 2.7% in FY 98, down from 3.8% the previous year.
About 50% of infusion therapy services provided from 1995 to 1998 to nursing home patients were medically unnecessary, says a Health and Human Services’ Inspector General’s Office audit. Among the findings: Suppliers charged skilled-nursing facilities up to 10 times the going rate for infusion drugs — a cost that was then passed along to Medicare. Three companies accounted for about 20% of the infusion therapy costs reimbursed on a national basis by Medicare.
Uninsured Americans in 1998 numbered 44.3 million, according to the Census Bureau. This is an increase of 833,000 over 1997 figures, even though in 19 states the number of uninsured residents decreased. Meanwhile, the number of uninsured children, says Physicians for a National Health System, rose by 330,300 in 1998.
Class-action lawsuits against HMOs are taking center stage. Aetna US Healthcare was the second HMO within a week to be hit. The suit, filed in U.S. District Court in Philadelphia, alleges that Aetna’s enrollees were not provided with adequate information on how the company makes its coverage and treatment decisions. Louisville, KY-based Humana was also slapped with a similar suit in Miami in which it was alleged that the company concealed information on how it decides which claims it will pay.
Two Columbia/HCA Healthcare executives convicted in July of Medicare fraud were granted a brief reprieve when their sentencing was delayed from Oct. 15 to Dec. 3, 1999. Jay Jarrell, president of Columbia’s Southwest Florida division, and Robert Whiteside, director of the company’s single-markets division, may be "crafting a cooperation agreement" that may result in a reduced sentence. Currently, the two are facing a maximum of 30 years in prison and $1.5 million each in fines.
Mount Sinai School of Medicine in New York City has paid $2.2 million to settle a Medicare fraud case related to the ongoing Physicians at Teaching Hospitals probe, which is looking into charges of questionable physician billing practices. Mount Sinai is the sixth academic medical center to resolve its charges since the investigation began four years ago.