Payers & Providers – Issue of February 3, 2011

8/7/2019 Payers & Providers Issue of February 3, 2011

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A prominent labor union says that hospitalsowned by Prime Healthcare Services claim totreat the highest rates of malnourished elderlypatients in the nation, suggesting it is a vehicle

for the for-prot chain to overcharge theMedicare program.

The Service Employees InternationalUnion-United Healthcare Workers Westcross-checked Primes Medicare fee-for-servicebillings against inpatient discharge dataprovided by the Ofce of Statewide HealthPlanning and Development. Among itsndings: 36% of the Medicare fee-for-servicepatients admitted at Primes Huntington BeachHospital in 2009 were treated for malnutrition the highest rate of any inpatient acute carefacility in the country.

I dont normally think of Huntington

Beach as a community where people arestarving, said Adam Weisberg, the SEIUanalyst who compiled and studied the data.

The nations second-highest rate, at 34%,belonged to another Prime property, MontclairHospital Medical Center.

The SEIU-UHW data also showed that 10of the top 40 hospitals in the U.S. for treatingMedicare malnourishment cases and 10 of thetop 11 in Caifornia were facilities owned byPrime.

Nearly 22% of all Medicare patientsadmitted to Prime hospitals were treated formalnutrition, compared to a 5.7% ratenationwide and 6.1% in California.

Those patients classied as severelymalnourished comprised 7.7% of all ofPrimes Medicare fee-for-service admissions,seven times the national average of 1.1%.

Moreover, Primes 13 hospitals in 2009treated 28% of all severely malnourishedMedicare patients in California, even though itadmitted and discharged only 4% of the entirestates inpatients.

Excluding Primes data, the malnutritiontreatment rate among California hospitalsdrops to 5.5%, which is below the nationalaverage, the SEIU claims. The severemalnutrition rate drops to 0.8% from 1.1%,

which is also well below the national average.Weisberg suggested Prime was using the

malnutrition coding in part to help boost itsMedicare claims. According to his analysis,Prime receives more than $7,100 perMedicare inpatient discharge, about $900higher than the national average, even whencontrolled for pricier specialty care.

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February 24-25

February 23

Calendar

3 February 2011

February 9

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[email protected]

the details of your event, or call(877) 248-2360, ext. 3. It will be

published in the Calendar section,space permitting.

California Edition

Union Accuses Prime of New OutliersHospital Operator Disputes Malnutrition Numbers

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In Brief

Tech Firms Pledge$150M Toward New

Stanford Hospital

Silicon Valley giants Apple,Hewlett-Packard, Intel, Intuit andOracle have pledged up to $150million over the next decade for theconstruction of a replacementfacility for Stanford Hospital &Clinics.

The pledges from the firms areexpected to help Stanford build a$2 billion, 1.3 million square footfacility that is expected toshowcase the cutting-edge inhealthcare technology.

Our corporate partnersrecognize that Stanford is uniquelypositioned to lead intranslating the next wave of

medical breakthroughs into carethat will benefit patientseverywhere, and that by investinghere, they can impact healthworldwide, said StanfordHospitals board chairpersonMariann Byerwalter.

In addition to the corporatepledges, Stanford University hasoffered the city of Palo Alto a $173million community benefitspackage intended to cut trafficcongestion around the new facilityand mitigate other environmentaleffects of the project.

Health Net Returns ToProfitability For Quarter,

But Enrollment Flat

Health Net reentered profitabilityfor the fourth quarter of 2010, butthe Woodland Hills-based insurerforecasts relatively flat enrollmentnumbers and revenue growth for2011.

Continued on Page 3

NEWS

Prime (Continued from Page One)

They have an incredibly high averageDRG, and get paid better than otherhospitals, he said.

The SEIU-UHW represents some150,000 healthcare workers in California. Ithas been involved in contentious battles overunion representation at Prime facilities.

In an especially combative statementissued by Prime on Tuesday, it claimedSEIU's malnutrition study is awed andrelies on themanipulation ofdata to arrive atdesired results.The companysaid thatmalnutrition is

prevalent in asmuch as 80% ofthe elderlypopulation thatseeks medicalcare, and that itis especiallyvigilant inassessing thehealth of itsolder patients.

Prime alsoaccused the SEIUof using data

against the hospital operator for the purposeof extorting favorable terms in collectivebargaining agreements. The rm has askedthe U.S. Attorney to investigate.

"SEIU-UHW stands rmly andunequivocally behind our analysis andndings regarding Prime Healthcare Servicesbilling practices, said a statement by theunion. The numbers have been validated byOSHPD, have been made available to stateand federal investigators and will withstandany and all further scrutiny.

OSHPD ofcials conrmed that itprovided data for SEIU to compare against

Medicare billings, but that it was notprovided with the unions nal study.

The SEIU-UHW report follows one itissued last year regarding extremely highlevels of septicemia among Primes Medicarepatients. It prompted concern by lawmakersand led to ongoing investigations by the U.S.Department of Health and Human Servicesand the Justice Department to determinewhether the Victorville-based Prime wasnegligent or engaged in Medicare fraud.

In its statement, Prime repeatedly calledSEIUs septicemia analysis bogus, andaccused the investigative journalism

organization California Watch of repeating thunions false and misleading statements,when it published an article last October

about the investigation.Lance Williams, a California Watch seniostaff writer who co-authored the article, saidthe article was completely accurate and stoodby his reporting.

Primes three-page statement issued onTuesday also accused former state Senator

Denise M.Ducheny ofwrongdoing.SEIU includedboth the SECand StateSenator Denise

Ducheney (sica long-timesupporter ofthe SEIU, in itsextortioncampaignagainst PHS,Prime alleged,adding thatDucheny alsotried to make iappear that itshospitals werenot seismically

compliant.Ducheny, a San Diego-area Democrat

who retired from the Legislature last year andnow serves on the California UnemploymentInsurance Appeals Board, denied that she hadever accused Prime of non-compliance withseismic regulations. She suggested that Primesingled her out over objections herconstituents raised to its 2007 purchase ofParadise Valley Hospital in National City fromnon-prot Adventist Health.

If I was engaged in extortion, I dontknow what I would be extorting, she said.

Sources have suggested that Prime issued

the statement whose tone is at completeodds with the mild rhetoric commonplace inthe hospital industry to try and deect anupcoming report California Watch hasprepared on the malnutrition data. Williamsdeclined to comment on whether hisorganization was working on such a story.

Prime also claimed its facilities had beeninspected within the past 60 days by theCalifornia Department of Public Health andno material deciencies were found. ACDPH spokesman said that 76 deciencieshave been found at 11 of the 13 Primefacilities inspected to date.

Hospital Malnutrition

Rate

Severe

Malnutrition

Rate

HuntingtonBeach Hospital

36% 15%

Montclair

Hospital

34% 9%

West AnaheimMedical Center

21% 9%

Desert Valley

Medical Center

33% 14%

Malnutrition rates among Medicare fee-for-service patients

treated at Prime Healthcare hospitals, 2009.Source: SEIU-UHW


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Page 3Payers & Providers

Longer ALOS!*

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NEWS

In Brief

Net income for the quarterending Dec. 31 was $80.4 millionon revenue of $3.7 billion. Thatscompared to a loss of $45.2million on revenue of $3.8 millionfor the fourth quarter of 2009.

For the 2010 calendar year,Health Net reported net income of

$204.2 million on revenues of$13.6 billion. For 2009, it lost $49million on revenue of $15.7million.

Company officials attributedthe turnaround to a focus on healthplans with narrower providernetworks, and more efficientoperations. Health Net was alsoable to repurchase $230 millionworth of shares in 2010, part of a$300 million share repurchaseprogram.

Although the companypledged improved performance for2011, it forecasts only a 1% to 2%growth in commercial enrollment,

and up to 7% growth among itsMedicaid plans. However, itforecast a 15% to 17% drop inenrollment in its MedicareAdvantage plans, connected to thecompanys recent marketingsuspension by the Centers forMedicare and Medicaid Servicesdue to repeated failures to supplypharmaceuticals to its Part Denrollees.

Revenue forecasts also predictHealth Net will finish 2011 withabout $1 billion less revenue thanin 2010.

Melody Named toAnthem Blue Cross

PostSteve Melody has been appointedto oversee Anthem Blue CrossMedi-Cal, Healthy Families andAccess for Infants and Mothersbusiness segments in California.

The segments, which Anthemrefers to as state-sponsoredbusiness, has more than 1 millionenrollees in California.

Melody, a 14-year veteran ofBlue Cross, was previously regionalvice president of planning andstrategy.

Under increasing pressure from regulators andconsumer groups, Blue Shield of Californiaagreed earlier this week to postpone for 60days rate increases on its individualpolicyholders as high as 59%.

Blue Shield agreed to delay the proposedrate increase on Tuesday, the same day its SanFrancisco headquarters was picketed by theSanta Monica-based advocacy groupConsumer Watchdog.

California Insurance Commissioner DaveJones had asked for the delay until an outsideactuary could conrm Blue Shields numbersjustifying the rate increase. Blue Shield agreedto the examination, but initially balked atholding off on the increase.

We are taking this action to remove andoubt that the rates we have submitted arenecessary to pay the medical expenses of ouindividual members, Blue Shield ChiefExecutive Ofcer Bruce Bodaken said in a

statement. Even with these increases, wedon't expect the premiums to cover the cost medical care for these members. Blue Shielclaims it loses about $30 million a year on iindividual policyholders.

Blue Shield delayed the rate hikes todawhen protesters showed up at their doorstepsaid Consumer Watchdog President JamieCourt. But they can raise rates in 60 days oany day after until we have tough laws that lregulators stop them and give consumers apublic option to the private market."

New data released by the Ofce of StatewideHealth Planning and Development indicatesthat 82% of Californias hospitals are expectedto be seismically compliant by 2015.

According to data released by the agencythis week based on submissions made by thehospitals, 403 buildings associated with 129hospitals are expected to be seismicallycompliant by the start of 2013. Another 153buildings associated with 55 hospitals areexpected to be compliant by 2015.

OSHPD reported that it expects structuresat only 16 hospitals to not be completelycompliant with seismic regulations by 2020,

which would likely force their closure toinpatients. That list included seven facilitiesoperated by Kindred Healthcare, a for-prothospital operator based in Louisville, Ky. AKindred spokesperson did not return a phoncall seeking comment.

Another hospital on the projected non-compliance list was Harbor-UCLA MedicalCenter in Torrance. However, ofcials with tLos Angeles County Department of HealthServices, which operates the hospital,disputed the OSHPD report, saying it wouldbe fully compliant by next year as it windsdown a $380 million retrotting project.

Most Hospitals Meet Seismic RulesOver 80% Compliant; Handful In Doubt For 2020

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Blue Shield Delays March Rate HikeRegulatory, Consumer Pressure Placed on Insurer
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Payers & Providers Page

There is no shortage of reasons why manyhospitals over the past decade struggled intheir transition to electronic health recordsand various forms of health informationexchanges. From implementation costs todisruption of daily operations to lack ofagreement on which platform to engage,the industry has been slow to responddespite the universal agreement that changeis upon us.!!!!!!As far back as the 1980s,forward thinkers were dreaming of alongitudinal patient record!thatwould follow a patient, for example,from hospital to outpatient care tohome care and back to the doctorsoffice. But with technology racing tocatch up to the dream, fewer than10% of American hospitals just adecade ago had implemented anyform of health informationtechnology, and a mere 16% ofprimary care physicians used EHRs.!!!!!!But that was then. Today,hospitals are universally recognizingthat the ability of health informationexchanges to facilitate access to and

retrieval of clinical data provides safer,timelier, more efficient and more equitablepatient-centered care. Whats more,hospitals are discovering that one of thehidden benefits of being the first in theircommunity to have an effective HIE is thedecided competitive advantage technologycan bring when it comes to interacting withthe local physician community.!!!!!!In California, most independentphysicians practice at multiple hospitals.!Which facility they choose to use is oftendetermined by comfort level and ease ofuse. Thats where technology can really set

one hospital apart from another. By havingan HIE platform that talks seamlessly tophysician offices, incredible efficiencies forthe hospital, the physician and the patientemerge. Physicians can effortlessly receivedischarge information on a hospitalizedpatient or on a patient of theirs who visiteda hospitals emergency department over theweekend. Electronically, physicians canreceive results of lab tests or otherprocedures performed at the hospital, and,conversely, tests done at the physiciansoffice wont need to be redone at the

hospital. Other savings include the time aexpenses associated with recovering misspatient information; manual printing,scanning and faxing of documents; thephysical mailing of entire patient charts; amanual phone communication to verifydelivery of traditional communications,referrals and test results.!!!!!!Why wouldnt a physician want towork with a local hospital where such eas

communication and increasedefficiencies become routine? Whamore, having the ability to conne

hospital and doctor electronicallwill be a huge advantage with themergence of accountable careorganizations which encouragehospitals to focus beyond their wand begin to think efficiency andvalue over volume. Nothing is abetter driver of efficiencies than

electronic connectivi ty.!!!!!!The key to making all of thishappen isnt just getting the hospitHIE technology in place, but

encouraging local physicians to go electroas well.! Until now that hasnt been easy, few single-shingle doctors were enthusito pay the costs associated with EHRs.Fortunately, there are now products on themarket at a price point that makes thistransition all the more doable. Combine thwith the financial incentives included in t2009 economic stimulus package and we already seeing a dramatic movement arouthe country of physicians anxious to embrEHRs as the next step in their practicedevelopment.!!!!!!2011 is destined to see manyhospitals migrate toward HIE technology.Making sure that their facility aligns with

local physicians and that they, too, areinvested in electronic health informationmakes good sense for everyone and shoula critical agenda item for every hospital inCalifornia.

OPINION

Opening The Floodgate For EHRsInstallations Will Rise As System Price Points Go Dow

By Brian

ONeill

Brian ONeill is cheif executive officer of

Office Ally in Vancouver, Wash.

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Op-ed submissions of up to 600 words are

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MARKETPLACE/EMPLOYMENTPayers & Providers Page 5

MEDICARE COMPLIANCE ADVISOR - ensures that L.A. Care and its subcontracted provider network is compliant with all Centerfor Medicare &!Medicaid federal regulatory requirements. This is achieved by participating in the annual PPG and quarterly auditsworking with internal and external staff to correct performance deciencies, identifying internal areas for improvement, serving a

the compliance contact with Plan Partners for member grievance oversight, provider services oversight, and interpreting CMS/SNPProgram requirements for L.A. Care. !Additionally, this individual is a resource to internal staff on compliance matters relating toCMS/SNP standards, including, but not limited to, marketing materials, grievances and appeals, member rights issues, and claimsadjudication.! Responsible for performing internal audits, monitoring for implementation of corrective measures, and interpretationof CMS requirements. !Working knowledge of federal and state requirements is required, as well as highly developed analytical skilland excellent verbal and written communication skills.!

For complete job description, qualications/requirements, visit our website: www.lacare.org

To apply, email resume with salary history and requirement to: [email protected] referencing Payers & Providers Ad

MANAGER, BUSINESS ADVISORY SERVICES

The Camden Group has been providing business advisory and management services to the healthcare industry exclusivelysince 1970. We have served more than 1,000 clients nationwide. Due to our growth, the following opportunity is available inour Los Angeles ofce:

Will prepare and manage the following types of projects: strategic plans, physician-hospital alignment strategy (e.g., ACO,clinical integration, bundle payment), service line development, and demand forecasts for presentation and collaboration withthe executive team members of hospitals, physician groups, and other healthcare organizations. The successful candidate willhave a high degree of direct client interaction, be responsible for managing projects, participate in the business development

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Payers & Providers MARKETPLACE/EMPLOYMENT Page 6

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Page 7Payers & Providers MARKETPLACE/EMPLOYMENT

SEEKING A NEW POSITION?

CAN HELP.

We publish advertisements for those seekingnew career

opportunities for just $1.25 a word.

If you prefer discretion, well handle all

responses to your ad.

Call (877) 248-2360, ext. 2, or [email protected].

Payers & Providers – Issue of February 3, 2011

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