News Briefs

HCA changes policies for discounting care

Hospital Corp. of America Inc., (HCA) the nation’s largest hospital company, said it has modified its policies on discounting patient care as of Jan. 1, 2005, based on recent guidance from the Centers for Medicare & Medicaid Services (CMS). The company, which has about $17 billion in annual revenues, will provide a discount to any uninsured patient receiving nonelective care who does not qualify for Medicaid or charity care. The CMS guidance, issued in late December 2004, confirmed that hospitals can offer discounts to any uninsured patient without putting the hospital’s Medicare payments at risk.

Another health care group, Triad Hospitals Inc., will expand its discount policy for self-pay patients effective April 1, 2005, to give all self-pay patients an initial discount off their total hospital bill, regardless of ability to pay. The discount will be commensurate with the local managed care discount at each hospital, the company said.

The new CMS guidance, released as an "FAQ," appears to confirm the information provided to hospitals last June that "individual determinations of need" are not required to offer discounts to uninsured patients. In March 2003, HCA implemented a sliding scale of discounts for uninsured patients with incomes between 200% and 400% of the federal poverty level. Under the new policy, HCA said its hospitals will attempt to qualify uninsured patients for Medicaid, other federal or state assistance, or charity care. If a patient does not qualify for those programs, the hospital will apply a discount similar to those it provides to local managed care plans.

"While these policy changes will help individual uninsured patients in many cases," said HCA chairman and CEO Jack Bovender Jr., "it will not solve the underlying issue of uninsured Americans. This country needs a broad-based solution to this problem."

Last October, Triad implemented a policy offering discounts to self-paying uninsured patients with limited ability to pay, with the discount based on each hospital’s location and each patient’s ability to pay. Triad initially offered the discount to all uninsured patients, but discontinued that component after comments by CMS that suggested it could affect Medicare reimbursement. "CMS recently clarified its position, and the company now expects that this component will not adversely impact Medicare reimbursement," Triad officials stated.

Framework’ endorsed for health data exchange

Thirteen health and information technology organizations have endorsed what they say is a "common framework" to support health information exchange in the United States while protecting privacy. The group presented David Brailer, MD, the national coordinator for health information technology, with recommendations for advancing the adoption of a national health information network that allows health care providers and patients to exchange health information to improve patient care.

The new environment, the organizations say, should be based on:

  • open, consensus-driven and nonproprietary standards and common methods for their adoption;
  • connectivity built on the Internet and other existing networks;
  • uniform policies that protect privacy, assure security, and support existing trust relationships.

The collaborative also recommends the use of financial incentives for the adoption of standards-based information technology in health care. Members of the group include the American Health Information Management Association, eHealth Initiative, Healthcare Information and Management Systems Society, and National Alliance for Health Information Technology.

On-line resources’ role increasing for seniors

On-line resources soon may play a much larger role in informing the nation’s seniors about their health and health care options, according to a survey by the Kaiser Family Foundation. While less than a third of seniors (65 and older) have gone on-line, more than two-thirds of people between 50 and 64 have done so, the national survey found. Just 21% of seniors have looked for health information on-line, compared with 53% of those between 50 and 64.

Similarly, the study found, 8% of seniors get "a lot" of health information on-line, compared with 24% of those between 50 and 64. Just 26% of seniors trust the Internet "a lot" or "some" to provide accurate health information, vs. 58% of people ages 50 to 64. Seniors rank the Internet fifth as a media source for health information; however, those 50 to 64 rank it first.

Standardization can save industry $77.8 billion

An analysis published recently on the Health Affairs web site ( estimates that standardizing electronic health care information exchange and creating interoperable information systems could save the nation’s health care system $77.8 billion a year. The authors, from the Center for Information Technology Leadership at Partners HealthCare System in Boston, add, "We suspect that the clinical payoff in improved patient safety and quality of care could dwarf the financial benefits projected from our model, which are derived from redundancies that are avoided and administrative time saved."

David Brailer, MD, the national health information technology coordinator, and other experts present their perspectives on health information exchange in accompanying articles.

Hospital consolidation not effective, study shows

A study published recently in the journal Health Affairs examines the impact on certain performance measures when a hospital consolidates into a health system, based on a sample of hospital consolidations in four states. The study, conducted from 1999-2000, at the height of the hospital consolidation trend, concludes that the consolidations on average did not increase efficiency, quality, or charity care within one year, although health plans on average paid higher prices to hospitals in the system.

Hospitals make the list of best places to work

Several hospitals were named to Fortune magazine’s 2005 list of "100 Best Companies To Work For," including Griffin Hospital in Derby, CT, which was ranked the eighth-best company and third-best small company to work for in the United States. The designation was based in part on the unique amenities the hospital offers its employees.

Other hospitals and health systems named include Baptist Health South Florida in Coral Gables (31 on the list); Bronson Health in Kalamazoo, MI (36); Memorial Health in Savannah, GA (48); Baptist Health Care in Pensacola, FL (59); and St. Luke’s in Houston (69).

The annual ranking is based on an evaluation of the organization’s culture and policies and a survey of its employees.