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Payers & Providers Midwest Edition – Issue of September 11, 2012

Payers & Providers Midwest Edition – Issue of September 11, 2012

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Published by PayersandProviders
Payers & Providers is the Midwest's premier healthcare business journal.
Payers & Providers is the Midwest's premier healthcare business journal.

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Published by: PayersandProviders on Sep 11, 2012
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05/13/2014

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September 23-25
Calendar 
11 September 2012
December 4-5
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Midwest Edition
E-Mailinfo@payersandproviders.comwiththe details of your event, or call(877) 248-2360, ext. 3. It will bepublished in the Calendar section,space permitting.
HealthPartners, Park Nicollet Merge
Deal Will Create $5 Billion Giant In Upper Midwest
Two of the Midwest’s most prominenthealthcare systems announced last week theywould merge, creating a multi-hospital systemoperating in two states.The merger of 
HealthPartners
and
Park Nicollet
, bothlocated in theMinneapolis suburbsof Bloomington andSt. Louis Park, isexpected to cut costsfor both theorganizations.Of 
cials with bothHealthPartners and ParkNicollet say they mergedorganizations will focuson reducing patientreadmissions, cuttingpatient infection rates,and expand the use of electronic medicalrecords in order to eliminate duplicative care.The transaction is expected to createopportunities for growth, through “sharedknowledge, care redesign efforts, pooledresources and investments and otheradvantages,” said
Jeremiah Whitten
, directorof media relations for Park Nicollet.However, Whitten noted that the groupswon’t begin looking at concrete opportunitiesuntil the agreement is effective, likely in early2013 pending regulatory approvals.Combined, the two providers will haverevenue of nearly $5 billion a year andoperate
ve hospitals, including two inWisconisn. They willalso operate a 1,500-physician medicalgroup and a healthplan with 1.4 millionlives.“In manyways, we’ve shownwhat’s possible whenhealthcare organizationswork together to putpeople
rst. Bycombining ourorganizations, we’ll takethat collaborative spiritmuch further, creatingnew potential formeeting the changingneeds of our community at this important timein healthcare,”said
David Abelson
, M.D., Park Nicollet’s chief executive of 
cer.Under the merger plans, the combinedentity would operate under the HealthPartnersname, which is much more broadlyrecognized in the Midwest. HealthPartners
 
MEET YOUR FELLOW READERS
Need to promote a conference? Or your brand?
Payers &Provider 
!   
e-mail list for all editions is available for yourmarketing needs. Reach out to more than 12,000healthcare professionals who read our publications. Callour advertising director
Claire Thayer
at (503) 226-9850,or e-mail her atclairet@mcol.com.
Continued on Next Page
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Payers & Providers
Page 2
Top Placement...Bottomless Potential
Advertise Here
(877) 248-2360, ext. 2
In Brief 
Illinois Hospital CEOResigns Suddenly
Dan Woods
resigned abruptly aschief executive officer of 
St.Anthony’s Memorial Hospita
l incentral Illinois.Woods, who had served asCEO for 12 years, announced hisresignation at a staff meeting latelast week. A hospital spokespersonsaid Woods’ decision to resign tookhospital personnel by surprise.The 146-bed St. Anthony’s,which is based in Effingham, is partof the Springfield-based
HospitalsSisters Health System
.In a prepared statement,Woods said he and his wife hadbeen considering his stepping downfor a significant length of time.However, he did not give a specificreason for his departure. 
Mark Reifsteck
, manager of Sisters’ Southern Illinois division,has been appointed interim CEO.The hospital spokesperson said itwould take about six months torecruit and hire a permanentreplacement.
HCSC, LungAssociation Work OnAsthma Initiative
The
Health Care Services Corp
. hasteamed with the
American LungAssociation of the Upper Midwes
tto improve asthma care to childrenin Illinois and the Southwest.The Chicago-based HCSCoperates Blues plans in Illinois,New Mexico, Oklahoma and Texas.It will work with the ALAUM toprovide more coordinated care to480,000 children with asthma,primarily through training atcommunity clinics that treat at-riskchildren. The training will be
Continued on Page 3
NEWS
Merger
(Continued from Page One)
CEO
Mary Brainerd
will retain that positionover the two organizations.Abelson will oversee the medical groupcomponent of HealthPartners, which will becalled the Park Nicollet HealthPartners CareGroup.The merger would place the combinedeneity among the top 10 largest employers inthe state, according to the
Minneapolis/St.Paul Business Journal 
.The transactionstrengthens Park Nicollet so it will hold upagainst other large providers in the region.No layoffs are expected to be held afterthe merger. And patients and members willcontinue to receive services from theirprovider and health plan withoutinterruption.The new organization will includemedical and dental clinics,
Park NicolletMethodist Hospital
in St. Louis Park,
Regions Hospital
in St. Paul,
LakeviewHospital
in Stillwater, Minn.,
HudsonHospital
in Hudson, Wis. and
West
eldsHospital
in New Richmond, Wis. 
– TAMMY WORTH
IOM Claims $750B Wasted Annually
Cincinnati Children’s Cited as a Success Story
“If home building were like healthcare,” saida new
Institute of Medicine
report,“carpenters, electricians, and plumbers eachwould work with different blueprints, withvery little coordination.”With physicians, hospital administratorsand insurance companies on often divergingbuilding plans, the idea that the healthcaresystem could fall apart like a badly builthouse is not surprising, according tocommittee members at a press conferencelast week. They called for collaborationacross different sectors of the industry.The cost of an inef 
cient system is nosmall burden: the institute, a nonpro
t thatadvises the government, estimated that $750billion was wasted on inef 
cient spendingand care in 2009.But the solutions, according to thereport, are not strictly
nancial. In thatreport, “Best Care At Lower Cost: The Path toContinuously Learning Health Care InAmerica,” a group of public health experts,physicians and scientists propose a strategyto make healthcare cost effective based onexamples of best practices in healthtechnology, leadership and administration.The 382-page report exhorts physiciansto keep up to date with technology, hospitalsto improve their management, patients tolearn about the system to make moreinformed decisions and scientists to usestricter standards to evaluate their research. 
Eugene Litvak,
one author of the reportand head of the
Institute For HealthcareOptimization
, said that hospitals have notbeen maximizing their productivity. He cited
Cincinnati Children’s Hospital
, a case studyin the report, and one of his organization’sclients, as a success story.By staggering the surgeons’ schedulesmore, for example, the hospital was able todecrease its physicians’ overtime and usemore of the costly patient beds that were
Contexo Media is an independent provider of revenue-enhancing solutions for medical practices to maximize their coding, reimbursement and compliance efforts. Thousands of health careprofessionals rely on Contexo Media’s coding books, software, eLearning and educational workshops to stay on top of critical updates across the fast-changing medical landscape.
 To learn more abou t our products and services, visit our website atwww.contexomedia.com
19144
By ANKITA RAO
Continued on Next Page
 
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Page 3
Payers & Providers
Longer ALOS!*
Advertise Here
(877)248-2360, ext. 2
*For our ads, not your hospital
NEWS
In Brief 
provided via HCSC’s Healthy Kids,Healthy Families initiative, whichaims to improve the health of 1million kids.“Public health experts,schools, and healthcare providersrecognize that poorly managedchildhood asthma is a pressingpublic health and social problem,”said
Paul Handel
, M.D., HCSC’schief medical officer. “We arededicated to addressing thisdevastating disease…we believethat education is the key tomanaging asthma.”
Michigan ResearchersCaution Against TightInsulin Control ForChildren UndergoingCardiac Surgery
University of Michigan
researchershave concluded that controllingthe blood sugar levels of pediatricpatients undergoing cardiacsurgery does not improveoutcomes,The study demonstrates thatchildren do not enjoy the samebenefits adult cardiac patients dowhen their blood sugar is closelymonitored and controlled. Overall,980 pediatric cardiac patientsundergoing cardiac bypassprocedures ranging in age fromnewborn to 3 years were closelyexamined. It was the largestclinical trial ever involving cardiacpediatric patients.“This study seems to indicatethat tight glycemic control shouldnot be standard practice inpediatric intensive care units forchildren who have had cardiacsurgery,” said Michael G. Gaies,M.D., a senior physician at theuniversity’s
C.S. Mott Children’sHospital
and the study’s leadinvestigator. “We will continueinvestigating new approaches toimprove both short-term recoveryand longer-term outcomes forchildren who need cardiacsurgery.”
often left empty. The adjustment spared thehospital the need to spend $100 million onnew beds.“These methods of operationsmanagement exist in every other industry –it’s only healthcare and education wherethey don’t,” Litvak said.The report also supports the highlydebated use of 
nancial incentives tomotivate doctors and others to be moreef 
cient. The authors said the new federalCenter for Medicare & Medicaid Innovationshould take the lead in evaluating paymentsystems.A graph in the report shows that $210billion was wasted on excess services in2009, which the authors said could havebeen avoided by rewarding physicians andhospitals who cut down on unnecessaryprocedures and treatment.But the incentive model has metresistance in the healthcare industry, andsome researchers have found that value-based incentives do not signi
cantly affect thecost of services. 
John Goodman
, head of the
NationalCenter For Policy Analysis
, said in aninterview that rewarding physicians in thisway was not an appropriate method to addressthe issue. He said that health care providersshould be able to choose how to run theirown programs.“I don’t think that the demand side shouldtry to tell the supply side what to do,”Goodman said.The IOM committee said that the U.S. wasspending up to 17% of its GDP on healthcare, a far higher proportion than otherdeveloped countries, and with very littleadditional bene
t. That not only affectsspiraling government spending on healthcare,but also siphons off resources that they saidshould be used for other public services suchas education.
(Provided by Kaiser Health Newswww.kaiserhealthnews.org
 
).
Report Follows Minn. Payer Profits
Plans Netted More Than $200M In Past Year 
million in income from Minnesota SeniorHealth Options, a program serving peoplereceiving Medicaid and Medicare.HMOs also saw pro
ts from employerplans. The report found that medical expenseswent down, while premiums increased. Thedifference between group premiums andmedical expenses increased from $48 in 2010to $66 in 2011.The report also found that enrollment incounty plans and HMOs fell by 5.1% in 2011.Even still, HMOs had a total of $1.743 billionin capital in 2011, enough to pay claims andoverhead for more than three months withoutother revenue coming in.
– TAMMY WORTH
A recent report found that Minnesota healthinsurers reported net income of $230 millionin 2011 on $7 billion of revenues. They wouldhave earned more, but four of the planscapped Medicaid and
MinnesotaCare
 underwriting income to 1% of premiums, or$103 million.The report is the 23rd annual MinnesotaHealth Market Review 2012 by
AllanBaumgartner
, a Minnesota-based analyst andconsultant. He has analyzed markets in otherstates including Illinois, Texas, New York andCalifornia.The state’s Medicaid income totaled$165.8 million – 8.5% of premiums – and $60
STORIES OF ONE HIGHLY LITIGIOUS PHYSICIAN
$149Call (877) 248-2360, ext. 1 to orderOR CLICK HERE
IOM
(Continued from Page One)

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