Scared of the bull. Not-for-profit hospitals are costing themselves millions with timid investment strategies

While level-headed noncasino-going people have accumulated tidy sums by judicious investing in higher-yielding debt and equities, the culture of hospital management and governance frowns on any financial risk. There are stirrings of change, especially among cash-rich systems. But naive as it sounds, some hospitals would rather stick with the tried-and-true than run with bulls.

Telemedicine program saves health system money, offers relief to rural providers

Allina Health System in Minneapolis set up an elaborate telemedicine program to offer big-city medicine and better coverage to rural hospitals in its regional network. Now, some rural hospitals are saving thousands of dollars and finding it easier to recruit and retain physicians.

The 1996 Justice Department/FTC statements on physician joint ventures and multiprovider organizations

The 1996 Justice Department/FTC statements suggest that under some market conditions, competitors who are members of a provider organization may fix prices if the agreement on price is reasonably necessary and subordinate to potential efficiencies created by the group. The author discusses to what extent agencies' statements protect an agreement on price among competitors from being challenged under the antitrust laws.

HealthEast Care: a direct contracting company

HealthEast Care has contracted directly with large self-funded Minnesota employers, including 3M, since 1992. These innovative direct contracting arrangements continue to demonstrate how collaborative efforts between health care purchasers and providers can be of advantage to those enrolled in self-funded and noninsured health plans. Insured HMO enrollment in Minnesota has been flat since 1991, while enrollment in self-funded plans and in noninsured public health plans has doubled during the same period. Minnesota is a bellwether state on the threshold of reform that will shift the power race for health care change from HMOs to purchasers and providers responding to consumer needs.

A unified health ministry in central Tennessee: eleven years of successful partnership

Middle Tennessee Medical Center (MTMC) is a not-for-profit community hospital located in Murfreesboro, Tennessee. Eleven years ago, a large investor-owned hospital company presented the institution's board of trustees with a purchase offer. As an alternative, two church-related institutions in Nashville--Baptist Hospital and Saint Thomas Hospital, which is part of the Daughters of Charity National Health System--presented the board of trustees with a plan whereby a new not-for-profit holding company sponsored jointly by Baptist Hospital and Saint Thomas Hospital would become the corporate member of Middle Tennessee Medical Center. Funds contributed by Baptist and Saint Thomas Hospitals would be infused into the Christy-Houston Foundation, a not-for-profit entity devoted to identifying and serving community needs in Murfreesboro and the surrounding area. Their proposal was accepted, and the two church-related institutions became partners in jointly sponsoring and governing an important not-for-profit healthcare institution in central Tennessee. In 1996, The Lewin Group, a healthcare consulting firm based in Fairfax, Virginia, was commissioned by Baptist Hospital, Saint Thomas Hospital, and Daughters of Charity National Health System to conduct a retrospective assessment of the progress of this jointly sponsored ministry in relation to the original vision and goals. Historical and operational data were analyzed, and interviews were conducted with 24 people who were directly involved in conceiving, developing, or implementing this ministry. This article summarizes the principal findings and conclusions of this ten-year assessment.

The costs of mergers and acquisitions in the U.S. health care sector

Important trends are emerging from evidence of health care industry concentration in the United States. Some of these are the durable consumer concerns--cost, choice, and access--which have received attention throughout the introduction of managed care. But with the intensified industry concentration, these have been joined by concerns about pricing power, control and quality, integrity of health system and health policy-making, and clashing institutional mandates. Such trends are particularly evident in the hospital and pharmaceutical industries.