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PubMed1990

Capitated Medicaid and St. Joseph's Hospital.

This case study presents the initial reactions of St. Joseph's Hospital and Medical Center, a large nonprofit hospital in Phoenix, Arizona, to the creation of a competitively bid, prepaid, managed care Medicaid program in 1982. It also presents the events in the first year of the Medicaid experiment and the subsequent reactions of the hospital. It illustrates the diverse set of issues that a hospital faces when it moves toward greater vertical integration in health care.

Arizona↗
PubMed1991

Women's hospitals redefine strategy.

As more general acute-care hospitals add obstetrical services, women's hospitals are being forced to re-examine the services they offer. Some are choosing to diversify, join a system or affiliate with a general acute-care facility. Others maintain that their facilities offer unique services unavailable at general hospitals and intend to remain independent.

Adult↗
PubMed1991

Hospital, system boards adjust to changing roles.

A growing number of multihospital systems are flexing their centralized power over individual hospital boards in an attempt to realize the competitive edge that systems were supposed to provide. As a result, governance at the hospital level is becoming more and more advisory. Obviously, trustees in a lot of locales aren't coming quietly into the new relationship. But experts say healthcare's financial climate makes such change just a matter of time.

Budgets↗
PubMed1990

Institutional alternatives to the rural hospital.

An important aspect of the ongoing debate on rural health policy is how to deliver inpatient care in sparsely populated rural areas. One alternative is to create a new classification of rural inpatient facility that would deliver more limited services than available in a rural hospital, have more flexibility in staffing requirements, and possibly be reimbursed differently. The support of the Health Care Financing Administration for the concept of a limited service rural hospital is critical, since such a facility would not be financially viable without Medicare payment. Several organizational and public policy issues that merit consideration in the design and implementation of institutional alternatives to rural hospitals are discussed, including licensure and certification, scope of services, personnel, quality assurance, and payment.

Hospital Administration↗
PubMed1991

Pennsylvania challenges hospital tax exemptions.

When a charitable hospital begins competing with businesses that normally are "for profit," such as laundries, the hospital stands a substantial chance of losing its state and county tax-exempt status. Nevertheless, healthcare organizations across the country routinely undertake commercial projects and amass profits without challenge. Here are two case histories that prove citizen involvement can spell the deathknell for unfair competition.

Charities↗
PubMed1991

When not-for-profit hospitals provide services, supplies outside the hospital.

Inquiries have been received about situations where not-for-profit hospitals provide services and/or supplies outside the hospital. Specific questions have been raised about hospice, home health care, nursing homes and ambulance services. In this dialogue, Dr. Decker examines the issues involved in such situations and makes some recommendations.

Commerce↗
PubMed1992

Competitive strategy for successful hospital management.

This study examined financial and operating data for approximately 1,000 U.S. hospitals categorized by Medicare as "large urban" to determine critical relationships between business strategy and financial performance. Cost control was found to be the most important factor influencing financial performance. Other factors of importance included market share, diversification, and financing policy.

Cost Control↗
PubMed1992

Virginia hospitals latest to face battles over tax exemptions.

Virginia has become the latest arena for efforts by local governments to tax the property or revenues of not-for-profit hospitals, which historically have enjoyed exemptions from such assessments. While one Virginia system already is paying a tax, another has made a donation to its municipal government to avoid being taxed. Several bills pending in the Legislature also could be taxing.

Charities↗