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BRIGHT IDEAS Hospitals Hoping Time Runs 20140915-NEWS--1-NAT-CCI-CL_-- 9/12/2014 3:55 PM Page 1 $2.00/SEPTEMBER 15 - 21, 2014 Hospitals hoping time runs out on SLAM DUNK midnight rule By TIMOTHY MAGAW [email protected] For some Medicare patients, sitting in a hos- pital bed overnight doesn’t necessarily mean they’ve been admitted. Consider it the Medicare version of purgatory, and it’s confus- ing patients and taking a chunk out of local hos- pitals’ bottom lines. Last year, the cash-strapped Medicare pro- gram instituted a rule that stated that patients needed two nights — make that two midnights — in the hospital to qualify for inpatient-hospi- tal rates. If they don’t cross that two-midnight threshold, hospitals must bill at the lower, out- patient rates. Basically, it injects a time element into a doctor’s decision of whether to admit a patient, and hospitals are clamoring for a change. “It is so convoluted now and under such fire they’ll have to do something to change it,” said Don Paulson, University Hospitals’ vice presi- CAVS’ dent of revenue cycle management. The rule, according to Moody’s Investors Ser- vice, has the potential to cost hospitals $3,000 to $4,000 per case. ‘ALL OHIO’ That’s big bucks, considering about 40% to 50% of most hospitals’ patients are Medicare beneficiaries. Moreover, Medicare patients are likely on the hook for more of the bill — co-pays APPROACH and drug expenses, for instance — when the hospitals are reimbursed at the outpatient rates. A boon in high-deductible health plans already has forced hospitals to up their game in collect- GAINS CRUCIAL ing unpaid bills, and the two-midnight rule SCOTT POLLACK would only intensify those efforts among See MIDNIGHT, page 24 MOMENTUM STORY BY KEVIN KLEPS n 30-second television commercials, the likes of Urban I Meyer, Archie Griffin, Thad Matta and Clark Kellogg proclaim themselves Cleveland Cavaliers. For the Cavs, captivating the attention of Columbus, Cincinnati and other markets outside Northeast Ohio has been a process that’s more than a decade old. Only now — with the return of LeBron James, the ac- quisition of Kevin Love and the focus of much of the NBA on Cleveland — the Cavs are playing from a position of strength. Kerry Bubolz, president of business operations for the Cavs, said the team, as the only NBA franchise in the Buckeye State, has “always felt like we should own Ohio.” DOWNTOWN OFFICE SPACE Following an offseason in which every conceivable AN ILLUSTRATED LIST, P. 22-23 See CAVALIERS, page 26 37 7 ALSO INSIDE: BRIGHT IDEAS NEWSPAPER Organizations and individuals must be careful and Entire contents © 2014 74470 83781 protect their intellectual property ■ Pages 15-21 by Crain Communications Inc. Vol. 35, No. 37 0 PLUS: STARTUP STORIES ■ TOP ADVICE ■ & MORE 20140915-NEWS--2-NAT-CCI-CL_-- 9/12/2014 1:03 PM Page 1 2 CRAIN’S CLEVELAND BUSINESS WWW.CRAINSCLEVELAND.COM SEPTEMBER 15 - 21, 2014 700 W. St. Clair Ave., Suite 310, Cleveland, OH 44113-1230 Phone: (216) 522-1383 Fax: (216) 694-4264 www.crainscleveland.com Publisher: John Campanelli ([email protected]) Editor: Elizabeth McIntyre ([email protected]) Managing editor: Scott Suttell ([email protected]) Sections editor: Amy Ann Stoessel ([email protected]) Assistant editor: Kevin Kleps ([email protected]) Sports Senior reporter: Stan Bullard ([email protected]) Real estate and construction Reporters: Jay Miller ([email protected]) Government Chuck Soder ([email protected]) Technology Dan Shingler ([email protected]) Energy, steel and automotive Tim Magaw ([email protected]) Health care and education Rachel McCafferty ([email protected]) Manufacturing and energy Research editor: Deborah W. Hillyer ([email protected]) Cartoonist/illustrator: Rich Williams Art director: Rebecca R. 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