SPECIAL LISTS ISSUE: 30 of the Largest Hospital Systems in America & More! INSIDE 291 Hospital & Health System Leaders Read our annual list p. 12 Hospital Review BUSINESS & LEGAL ISSUES FOR HEALTH SYSTEM LEADERSHIP A CEO Walks Into September/October 2011 • Vol. 2011 No. 7 a Patient Room Q&A With UCLA Health’s Dr. David Feinberg p. 20 The Quiet Takeover: Changes Insurers Buying Ahead: Chuck Lauer: Orchestrating Four Generations Physicians and Hospitals Medicare IPPS in Your Hospital p. 30 By Molly Gamble 2012 and What The ACO Payors might provide more than reimbursement in the next few years It Means for Conundrum — they may be signing the check to buy your hospital or the physicians How to Achieve Accountable that drive your referrals. Hospitals Care While Avoiding Downfalls of Medicare ACOs p. 40 Payors buying physicians By Molly Gamble Two related but distinct trends are emerging, and quietly: insurers Medicare and hospitals go hand in hand. buying physician groups and insurers buying hospitals. The first INDEX Hospital payments account for the continued on page 8 greatest share of the federal program’s Executive Brief: spending, and Medicare is the largest Ambulatory Services p. 25 payor for hospital services, comprising Hospital Finance p. 38 Patient Experience: a significant portion of most hospitals’ Hospital Physician revenue. As of Oct. 1, though, hospitals Relationships & ACOs p. 40 An Increasingly Critical will operate under a revised inpatient Hospital Transactions & prospective payment system — one that Valuation Issues p. 42 Hospital Indicator could prove costly to many hospitals. Stark, Antikickback & By Lindsey Dunn The changes to the Other Regulatory Issues p. 43 Hospitals have long tracked patient satisfaction ratings, but they didn’t IPPS for fiscal year Executive Briefing: always carry great significance. While all hospitals want happy patients, 2012 Hospital-ASC Joint hospitals have been historically plagued with the “doctor knows best” Imagine if the method of assessing indi- Ventures p. 45 mentality — a mentality where clinical outcomes outweigh “touchy-fee- vidual taxes changed and the government Compensation p. 50 ly” indicators such as patient satisfaction or overall patient experience. scrapped its traditional income-based ap- proach for a model that taxed Americans Executive Briefing: HIT/ Meaningful Use/EMRs p. 53 However, in recent years, some leading institutions have begun to focus based upon their personal caliber. more heavily on providing an outstanding patient experience. Part of this Hospital & Health System has been driven by the public reporting of Hospital Consumer Assess- This may sound far-fetched, but health- Transactions p. 60 ment of Healthcare Providers and Systems scores, which will soon be care leaders might share a strange yet Hospital & Health System Executive Moves p. 62 continued on page 10 continued on page 38 REGISTER TodaY! 18th Annual Ambulatory Surgery Centers Conference — Improving Profitability and Business and Legal Issues The best annual ASC business, legal and clinical conference 90 sessions, 132 speakers October 27-29, 2011 • Chicago, Westin Michigan Avenue To register, call: 703-836-5904 or email [email protected] www.BeckersASCReview.com Go Paperless and Get Paid Register NOW for CMS Electronic Health Record Incentives The Centers for Medicare & Medicaid Services (CMS) is giving incentive payments to eligible professionals, hospitals, and critical access hospitals that demonstrate meaningful use of certified electronic health record (EHR) technology. Incentive payments will include: UÊ Up to $44,000 for eligible professionals in the Medicare EHR Incentive Program UÊ Up to $63,750 for eligible professionals in the Medicaid EHR Incentive Program UÊ A base payment of $2 million for eligible hospitals and critical access hospitals, depending on certain factors Get started early! To maximize your Medicare EHR incentive payment you need to begin participating in 2011 or 2012; Medicaid EHR incentive payments are also highest in the first year of participation. Registration for the EHR Incentive Programs is open now, so register TODAY to receive your maximum incentive. For more information and to register, visit: www.cms.gov/EHRIncentivePrograms/ For additional resources and support in adopting certified EHR technology, visit the Office of the National Coordinator for Health Information Technology (ONC): www.HealthIT.gov What lane is your patient access process in? MedeAnalytics’ Patient Access Intelligence fast tracks the patient financial clearance process, making it more streamlined and efficient. Here’s what it can do for your organization: ■ Reduce bad debt by 10% ■ Increase pre-service cash collections by 30% ■ Reduce errors and avoidable denials by 40% ■ Increase Medicaid reimbursement by 3% ■ Eliminate redundancy and manual processes Visit www.medeanalytics.com/pai or call MedeAnalytics at 510-379-3300 to learn more. ª.FEF"OBMZUJDT *OD"MMSJHIUTSFTFSWFE )'."TUBGGBOEWPMVOUFFSTEFUFSNJOFEUIBUUIJTQSPEVDUIBTNFUTQFDJmDDSJUFSJBEFWFMPQFEVOEFSUIF)'."1FFS 3FWJFX1SPDFTT)'."EPFTOPUFOEPSTFPSHVBSBOUZUIFVTFPGUIJTQSPEVDU PAI_beckers_0411.indd 1 4/12/11 2:51 PM #1056 SD-Beckers Ad RV5 q7:Layout 1 6/23/11 6:20 PM Page 1 P R O F I T A B I L I T Y T H R O U G H P E R I O P E R A T I V E I M P R O V E M E N T IMPROVEYOUR BOTTOM LINE. Surgical Directions solutions are driven by measurable results and the belief that culture change leads to sustainable operational success. Surgical Directions consistently helps hospitals improve their perioperative performance. Over the past five years, we have changed the culture, and most importantly, improved the bottom line for more than 200 clients: from community-based hospitals to large quaternary academic medical centers. Our multi-disciplinary teams of anesthesia, nursing and business consultants typically help hospitals improve profitability by $250,000 – $750,000 per OR by improving: � Surgeon Satisfaction � Materials/supply spend � Turn over time � Labor spend � Close to cut time � Anesthesia service Levels � On time starts � And growing incremental � Block Time OR Volume Let our clinically active professionals discuss issues that you currently have in the OR as well as strategies other organizations have successfully used to address similar issues. Contact us to schedule a free, no obligation conference call to review your situation. Surgical Directions. Helping improve your perioperative service, enhancing your bottom line! perioperative & anesthesia consulting · assessment · interim management 312.870.5600 www.surgicaldirections.com Are you ready? 9ʑUʣLʝɚ 'HDɮʙʖȸɏ ƯDŽ1Vɢ ,Ǩ''HDɮʙʖȸɏ 2&7Vɢ Official CMS Industry Resour ces for the ICD-10 T www.cms.gov/ICD10 ransition 6 Register today for the 18th Annual Ambulatory Surgery Centers Conference. Call (703) 836-5904 Hospital Review BUSINESS & LEGAL ISSUES FOR HEALTH SYSTEM LEADERSHIP September/October 2011 Vol. 2011 No. 7 www.BeckersHospitalReview.com Editorial features Lindsey Dunn Editor in Chief 7 Publisher’s Letter 800-417-2035 / [email protected] 12 291 Hospital and Health System Leaders to Know Rob Kurtz 18 60 Hospitals With Great Orthopedic Programs Editor in Chief: Becker’s ASC Review 800-417-2035 / [email protected] 20 A CEO Walks Into a Patient Room: Q&A With Dr. David Feinberg, CEO of UCLA Rachel Fields Health System Associate Editor Becker’s Hospital Review Special Issue: Lists & Statistics 800-417-2035 / [email protected] 22 25 Largest Non-Profit Hospitals in America Laura Miller Assistant Editor 22 25 Largest For-Profit Hospitals in America 800-417-2035 / [email protected] 23 25 Top Grossing Non-Profit Hospitals in America Molly Gamble Assistant Editor 23 25 Top Grossing For-Profit Hospitals in America 800-417-2035 / [email protected] 24 15 Largest Non-Profit Hospital Systems Bob Herman 24 15 Largest For-Profit Hospital Systems Writer/Reporter 800-417-2035 / [email protected] Executive Briefing: Ambulatory Services Jaimie Oh 25 A New Approach to Ambulatory Services Writer/Reporter 800-417-2035 / [email protected] 30 Orchestrating Four Generations in Your Hospital Leigh Page 31 Brochure for Improving Profitability and Business and Legal Issues Conference Writer/Reporter 800-417-2035 / [email protected] Hospital Physician Relationships & ACOs Sabrina Rodak 40 How to Achieve Accountable Care While Avoiding Downfalls of Medicare ACOs Writer/Reporter 41 Survey: 33% of Hospital Executives Plan to Join ACOs, But Less Than 7% Believe 800-417-2035 / [email protected] Model Improves Quality SALES & PUBLISHING Hospital Transactions & Valuation Issues Jessica Cole 42 5 Foundational Questions for Hospitals Acquiring Physician Practices President & CEO 800-417-2035 / [email protected] Stark, Antikickback & Other Regulatory Issues Ally Jung 43 Pennsylvania’s Divine Providence Hospital Settles Improper Payment Allegations Asst. Account Manager 800-417-2035 / [email protected] 43 Federal Investigation Looks for Stark, Anti-Kickback Violations at Broward Health Austin Strajack 43 Community Health Systems Receives SEC Subpoena Asst. Account Manager 43 Florida’s St. Luke’s Hospital Faces False Claims Allegations 800-417-2035 / [email protected] 6-Year-Old Whistleblower Suit Against IASIS Healthcare Alleging Kickbacks is Dismissed Brittney Wichtendahl 43 Assistant Account Manager Executive Briefing: Hospital-ASC Joint Ventures 800-417-2035 / [email protected] 45 12 Decisions That Can Cripple a Surgery Center Maggie Wrona Assistant Account Manager