Hospitals that implement noncompetitive clauses in their contracts, do so to protect their organization if a current doctor decides to leave and practice elsewhere. The clause states the restrictions of the physician’s practices, including the time period and location. This particular contract restricted Dr. Dominy from performing emergency medical services in only MHM in Bainbridge, Georgia and from having an ownership or financial interest in an entity contracting to provide emergency medical services to that one hospital (Pozgar &…
Health Management Associates is a Naples-based for-profit hospital chain that owns 71 hospitals, 23 of which are in Florida (newspress). There have been many whistleblowers within the company that have brought allegations against HMA for focusing on the profits of the company over the proper medical attention of patients. In August 2013, the major shareholder of HMA, Glenview Capital Management LLC, with about 9.6% of stocks lead to the complete removal of the board of directors. There is currently a merger occurring in which HMA will go under another for-profit hospital chain company called Community Health Systems which will form the second largest for-profit hospital chain by revenue (nytimes). Glenview also pushed for this (fierce). The Department of Justice is backing many of those who have reported claims through qui tam cases. The CEO, Gary D. Newsome, left the company a few months ago to lead a mission trip, but is currently part of the cases as well. Several of the lawsuits point to Newsome as the inventor of the strategy used to raise admissions to emergency rooms (nytimes). The idea here is that the company gives incentives to the doctors to admit more patients to the emergency room to meet a quota. There are reports of the company using a software called Pro Med to keep scorecards for the doctors. The goal is to admit at least half of the patients over 65 that visit, the scorecards have the doctors highlighted in different colors: green for on target, yellow for those who were close, and red for doctors that were failing. Jacqueline Myers, a worker for the company that hires the doctors used by HMA, reported that she received the order to fire the doctors and red, but said no followed by being fired (nytimes). A CFO in a Georgia branch of HMA did a separate investigation of the admission rates and found them to be higher compared to other hospitals.…
Anti-trust laws were created top prevent larger companies and organizations from pushing smaller entities out of the ability to fairy compete for business. Mr. Oltz received a settlement from the hospital initially but was later unable to recoup legal fees and damages from the hospital once the trial judge ruled the damages were excessive. This case is a great example of what anti-trust laws were designed to do and who the laws are intended to protect. Mr. Oltz unfortunate encountered difficulty with getting his legal fees paid based upon a technicality, however this case did shed light on the conspiracy at elimination of competition among anesthesiologists in St. Peter’s Community…
Cannon, Michael F and Michael D Tanner. Healthy Competition : What 's Holding Back Health Care and How to Free It (2nd Edition). Washington, DC: CATO Institute, 2007. Book.…
Derreck Fryar has great work ethic and he is really dedicated to his work. He only missed two team meetings and one missing is because he attended the new employee orientation. He is willing to work late to solve problems with his teammates anytime. An example is that he works hard to solve an emergency damage control for our important client.…
Eighty percent of patients at RRMC were Medicare or Blue Cross and the administration experienced much difficulty when it came to negotiating prices with Blue Cross due to monopoly”(Richards & Slovensky, 2004). In this market, buyers have high bargaining power because reimbursements rates are low. Because Medicare and Blue Cross held monopoly in these services area, negotiating prices remained extremely difficult for RRMC. The suppliers have lower bargaining power due to low Medicare reimbursements and difficulty negotiating prices with Blue…
References: olam v. Feirn Hospital Management Committee (1957) 1 WLR 582. Document No:C1745651, From Lawtel DatabaseBrazier, M. (1992) Medicine, Patients and the Law. 2nd ed. Penguin books: London, UK.…
The cost of health care in the United States remains an important concern for American consumers. The challenges for controlling costs and providing a better health care system are various and complex. These challenges, in many cases, are in the realm of the Department of Health and Human Services (HHS) or other federal or state agencies (Department of Justice, 2012). Hospitals continue to team up with other facilities, insurers and for-profit companies, although the cause of the bump in M&A activity varies. While some hospitals cite financial problems, others join forces because of collaboration mandated under the Affordable Care Act and changing reimbursement models, according to Minnesota Public Radio (Caramenico, 2012).…
As a result of the Patient Protection and Affordable Care Act of 2010, beginning in October 2012, US hospitals will begin having their payments from Medicare affected by the Hospital Value-Based Purchasing Program. Essentially, this legislation will shift the way hospitals are reimbursed for services from a focus on quantity to a focus on quality. The following research study will examine the background of this legislation, how it is structured, and the pros and cons of this reform.…
When a physician office practice is purchased by a hospital system, the hospital system takes over the fixed costs like office expenses as well as administrative tasks like scheduling. Most important, are upgrades to electronic health records that comply with federal mandates CITATION McK13 \l 1033 (McKinsey, 2013). These are very costly and become a responsibility borne by the purchasing hospital system. It is clearly an attractive option of physicians. However, research indicates that the hospital systems themselves are losing money on the transactionsCITATION Num13 \t \l 1033 (Numerof, 2013). According to Moody’s hospital systems that purchase physician practices see an average increase of 5.2% for salaries. This is a major increase considering the thin margins hospitals operate on (Moody’s 2013). Most hospitals see a net loss on their investment in physician practices (Moody’s 2013). Why then would they do it? The reason lies in control. In exchange for shuffling off the risk of operating a practice to the hospital system, the physician gives up some measure of autonomy. Hospitals can directly contract a physician’s behavior and incentivize his prescribing behavior CITATION Hea13 \l 1033 (Healthcare Economics Editorial Board, 2013). This is unique, as not even payers could so directly influence a physicians practice. This means that the financial interests of the…
• There are 3 reasons that hospitals merged or consolidated and they are: drawing on the strengths of the other facility, seek help with struggling finances, and the gain of a demographic advantage that makes it more convenient for patients to travel to (healthcarefinancenews.com, 2013). This would impact the hospital by helping those hospitals struggling to make it financially (healthcarefinancenews.com, 2013). Capital needs and technology needs are assisted with merging into a bigger system (healthcarefinancenews.com, 2013). This also allows for a rise in accountable care organizations amongst merging…
Anti-trust laws in the United States have been effectively used to prevent monopolies in industries like telecommunications, oil and gas and computer software. Anti-trust laws are enforced in order to maintain free competition in the marketplace, which generates lower prices and incentivizes the development of high quality products. Today, hospital systems are experiencing an era of heavy consolidation, which include mergers and acquisitions and physician practice buy-outs. According to the Wall Street Journal, hospitals completed 86 merger and acquisition deals valued at $7.9 billion in 2011, which was the most in a decade. Like in other industries, this developing trend in hospital consolidations encourages price fixing and contributes to rising healthcare costs and excessive medical billing. In order to manage healthcare costs in the United States and address unfair medical billing practices, anti-trust laws should be enforced within the healthcare industry.…
R., & Kiyak, H. A. (2008). Personality and mental health in old age. In Social gerontology: A multidisciplinary perspective (8th ed., pp. 223-258). Retrieved from https://usc.ares.atlas-sys.com/ares/ares.dll?SessionID=U214440684U&Action=10&…
Feldman, Roger D. American Health Care Government, Market Processes, and the Public Interest. New York: Transaction, 2000. Print.…
Baker, L., McClellan, M., Managed Care, Health Care Quality, and Regulation. The Journal of Legal Studies, Vol. 30, No. 2, The Regulation of Managed Care Organizations and the Doctor-Patient Relationship (Jun., 2001), pp. 715-741…