Hospital Associations in California Set Up 2 Non Profit Foundations to Help Small and Independent Hospitals Contract with MDs
Posted Nov 09 2010 12:56pm
This is not surprising in view of what occurred at the City of Hope and yes this is stressful for both hospitals and doctors and some of the carpet is being yanked up here that has been around for years. in other states, doctors can work directly as employees for hospitals, but in California the law prohibits this practice, so every hospitals works with physician’s groups with contracts. The City of Hope just won their appeal to be able to create a new group and disbanded the former physician’s group that has been represented at the hospital. There’s additional information and links on the history of this case below.
This all melts down to the creation of ACOs, Accountable Care Organizations to get physicians and hospitals to work together. The California Medical Association has released their guidelines to help in this effort.
Medicare compensation schedules and rules are creating the environment for all of this to change as they pay more for procedures performed in a hospital environment or owned clinic in some instances and thus hospitals may be showing some additional interest in buying up MD practices along the line, that is if they have the money as about half of the hospitals in the LA area are in the red.
As patients, these battles don’t tend to do anything for us other than have the potential to disrupt and add confusion at times as where care if offered and by whom has the potential to change as contracts change and we see that in the news all the time anymore. I still contend that changes in the transaction fees and software required today to get paid need reform too as that is one of the most expensive, lucrative and confusing areas of care today.
So we can’t blame Medicare entirely as even commercial insurers are leaving doctors and hospitals scratching their heads too on how to comply with some of the data, formats and reporting they want in order to provide coverage. Coding and modifiers to the rescue at times to complicate even further. It’s all about those cost algorithms today.
Recently in Los Angeles we had the “Accountable Care Congress” formed and was lead by the CEO of Hoag Hospital in Orange County for ideas and culminating on how to work together.
Algorithms for operation – as you might say these have been a direct result from Wall Street methodologies, as look where those algorithms worked for them, they have all the money and basically over a number of years have redistributed the financial sectors of most businesses in the US to include healthcare. BD
After months of deliberation, the Hospital Association of Southern California and the Hospital Council of Northern and Central California have established two private, not-for-profit foundations to help small and independent hospitals contract with physicians, the Los Angeles Daily Journal reports.
Daniel Settelmayer -- a partner at the firm Latham & Watkins -- said the two California foundations will be established in Northern California and in Southern California. He has not said how many hospitals have agreed to participate in the foundations.
The not-for-profit foundation model is viewed as a way to share resources and control health care costs to align with the goals of the federal health reform law. The reform law encourages health care providers to form accountable care organizations, which seek to bring together hospital systems and physicians to provide coordinated care.