Scott campaign defends his record as head of hospital chain - Sun-Sentinel

Florida gubernatorial candidate Rick Scott's campaign motto is simple: "Let's get to work."

It's a job-creation slogan voters can identify with during tough economic times and record unemployment rates.

"I'm the only candidate in this race who has built businesses and helped create tens of thousands of jobs," the Republican says on his campaign website.

Scott's record as the chief executive of Columbia/HCA Healthcare Corp. during the 1990s tells a more complex story.

Under Scott's tenure, Columbia cut more than 5,000 jobs at hospitals nationwide, according to state statistics and a review of news reports on the company's business practices.

Columbia snapped up hospitals from Miami to San Jose. Job losses followed in many markets it entered.

"He would buy hospitals and close them," said Michael Lighty, director of public policy for National Nurses United, a nurses union. "I can't think of a community where his involvement led to a net increase in jobs."

Scott grew his company and became one of Florida's largest private employers largely through acquiring big hospital chains. He picked up independent hospitals and built a handful of others. As the health care industry downsized, Scott earned a reputation for cutting staff, consolidating operations and closing hospitals.

At a campaign stop in Broward last week, Scott dodged a question about Columbia's employee cuts and instead touted his plan to create jobs in Florida, a cornerstone of his campaign.

"As governor, I'll be Florida's Job Creator-in-Chief," his website says. "We won't miss any opportunity to keep or add jobs."

Scott spokesman Brian Burgess said in a statement to the Sun Sentinel that "Columbia closed some hospitals because they were simply not being fully utilized [under capacity, empty beds, etc.]"

"New jobs were created regularly — at individual hospitals, laboratories, surgical centers, regional and national headquarters," Burgess said. Scott also created jobs after he left the company in 1997, the statement said, by investing in private sector businesses and starting a chain of urgent care clinics in Florida that employ 541 people.

Burgess said the campaign had no way of providing any numbers in support of Scott's statement that he created "tens of thousands of jobs" but called it an estimate over his entire career that started with the purchase of doughnut shops while in college.

Calculating a definitive number of jobs lost or added by Scott is difficult. HCA, as his former company is now called, does not have those numbers, nor are they in publicly available annual reports. Layoffs alone do not tell the whole story, Scott's campaign said, and some affected employees were offered other positions in the company.

Scott, 57, started Columbia in El Paso, Texas, in 1987, with the purchase of two hospitals. The young health care attorney bought a third hospital there the following year and shut it down.

It was a pattern that would be repeated as Scott's company aggressively moved into Florida.

'Big uproar'

In the mid-'90s, Columbia/HCA operated more than 50 hospitals throughout the state. Under Scott's leadership, the company consolidated or closed eight Florida hospitals that had employed more than 1,500 people, according to the state Agency for Health Care Administration.

He entered the Florida market beginning in 1988 with the purchase of Victoria Hospital in Miami. Columbia later closed Victoria and shifted its operations to another of its hospitals, Cedars Medical Center, where the staff was cut, eliminating roughly 700 jobs, according to news reports at the time.

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Prescription for success - Albany Times Union

The Census Bureau recently reported that the number of people without health insurance in the United States climbed 10 percent between 2008 and 2009, from 46.3 million to 50.7 million, over 15 percent of the nation's total population. This significant increase reflects the state of our economy, increased joblessness among the general public and, even among those with employment, the continued retreat of many employers from providing health care coverage to their workers.

According to the Census Bureau, the percentage of individuals covered through employer-sponsored plans is now at a record low 56 percent. But stay tuned, because over the next couple of years, this figure will rise further and likely not begin to decrease until 2014, when the country makes affordable health insurance available to many more citizens.

Despite these sobering statistics, some still question the merits of our recent health care reform legislation, which finally put in place a safety net for the millions of Americans without health insurance coverage, and for the millions who lose their coverage suddenly, to get it.

Focusing on the economic arguments, reform was and continues to be a no-brainer. First, there is little doubt of the economic costs to employers and the country at large from having a sicker population. Having health insurance is a key predictive factor in whether or not a person stays healthy in the first place.

More uninsured individuals translate into more lost work time and lower productivity for the nation as a whole. We talk in vague terms about "how much" providing health care insurance may cost the country. But what must be remembered is the hundreds of billions of dollars we save by making sure millions more Americans are healthy enough to go to work each day.

For example, a 2003 Commonwealth Fund study concluded that "labor time lost to health reasons" in the United States amounted to more than $250 billion annually. This same survey found that more than 400 million days of work in a single year were lost as a result of worker illness.

Arguments about how much health reform may cost to implement are incomplete when they do not also consider the productivity gains, economic growth and increased standard of living generated over time by having more people working regularly and moving up in their job titles and earnings as a result of the steady employment that comes from being in good health. One of the little known yet most important reasons for our nation's ascension to world economic power over the past 50 years has been the presence of a strong health insurance system to enable American workers to seek care when they need it.

The second valid economic argument justifying expanded health insurance in this country is that the health care sector represents the second largest spending component of our nation's Gross Domestic Product, behind only the military.

According to the Bureau of Labor Statistics, education and health services provide almost one in every five jobs in the United States. The bureau also reported that in 2009 and thus far in 2010, the health care industry has been adding 20,000 new jobs a month across the United States.

Despite our economic meltdown, the health employment sector remains strong, and is a vital ingredient to digging ourselves out of the Great Recession. Nowhere is this seen more clearly at a local level than in the Capital Region, which relies on hospitals, large physician practices, several major insurance plans and countless other health-related businesses to provide tens of thousands of jobs. Without a vibrant health care industry in our area, there would be many more individuals out of work, more houses facing foreclosure, more quickly dropping property values and increased taxes levied on everyone.

When we focus on health insurance's contribution to creating a healthy and productive work force, investment in health reform is a sound investment that will more than pay for itself over time. With our national and local economies in shambles and jobs in short supply, we should embrace any policy that will invigorate the second largest sector of our economy.

Do we need additional health reforms?

Absolutely. These additional reforms must focus on the supply-side problems in our health care industry that include the fragmented and duplicative nature of service delivery, the use of unproven diagnostic and therapeutic approaches that cost too much and the continued problems with customer dissatisfaction and poor quality. It is far from a perfect system, and the underlying business model of "get sick, and then get cared for" must be transformed to one that emphasizes "keep us healthy and prevent illness."

But allowing millions of people to have health insurance at a time when the work force is getting older and sicker and becoming increasingly uninsured is a smart strategic move for our region, state and nation, even if we cannot yet agree on the moral imperative of it all.

Unlike the recent federal stimulus and Wall Street bailout, it will produce a multiplier effect for our economy that will last far longer and help pull us out of this mess for good.

Timothy Hoff, Ph.D., is associate professor of health policy and management at the University at Albany School of Public Health, He is the author of "Practice Under Pressure: Primary Care Physicians and Their Medicine in the Twenty-First Century."

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Home healthcare shrs down as Amedisys gets DoJ letter - Reuters

* DoJ seeks documents on claims submitted to Medicare

* Amedisys says intends to cooperate with DoJ

* Gentiva, LHC, Almost Family shares down (Recasts, adds analyst comment, updates share movement)

By Suzannah Benjamin

BANGALORE, Sept 28 (Reuters) - Shares of U.S. home healthcare companies fell Tuesday after Amedisys Inc (AMED.O), which is being investigated by regulators over its billing practices, said the Department of Justice asked for information on claims it submitted to Medicare.

Amedisys shares fell 17 percent, while Gentiva Health Services Inc (GTIV.O), LHC Group Inc (LHCG.O) and Almost Family Inc (AFAM.O) were down about 4 percent.

In a civil investigative demand issued under the False Claims Act, the DoJ sought documents related to reimbursement and billing claims, Amedisys said in a statement.

In May, a U.S. Senate Finance Committee had launched an investigation over billing practices that it said raised questions about reimbursement from the Medicare insurance program. [ID:nN13162384]

In a bipartisan letter to Amedisys, Gentiva, LHC and Almost Family, lawmakers had said it appeared the companies increased billing to help boost their profits.

The U.S. Securities and Exchange Commission had launched similar probes into the billing practices.

Civil investigation demands may be forthcoming for the other companies as well, given the reviews by the SEC and the Senate Committee, said Kevin Campbell, an analyst at Avondale Partners.

However, it is too early to know if the DoJ request is related to the regulatory reviews of the industry, he said.

The DoJ demand covers the period from Jan. 1, 2003 through the present, Amedisys said, adding that it is cooperating with the department.

The DoJ's demand could impact Amedisys' volumes in the home health business, Sheryl Skolnick, an analyst with CRT Capital Group said. It may hit admissions as well, she said. (Editing by Maju Samuel and Vinu Pilakkott)

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Blue Cross tests 'medical home' model - Omaha World-Herald

Improving patient care and curbing rising health care costs are among the goals of an effort Blue Cross and Blue Shield of Nebraska is launching on Friday.

The six-month trial program involves primary care doctors, clinics and patients in nine Nebraska cities including Omaha, Lincoln and Kearney.

The program is intended to test the effectiveness of the “medical home” model. Under that model, a primary care doctor is established as the main provider and coordinator of a patient's health care needs, said Dr. Bill Minier, vice president and chief medical officer for Blue Cross.

The primary care doctor not only will provide routine exams, but also will coordinate the care that patients receive from outside specialists, he said.

The goal is for the primary care doctor to ensure that the patient is getting necessary care and that needed tests and follow-up exams are not falling through the cracks.

The medical home model is an idea that has received attention during the health care reform debate as a way to strengthen doctor-patient relationships.

The primary care doctors will use an Internet program that creates medical checklists that are tailored for each patient. The checklist will help the primary care doctor know, for example, if it's time for a certain immunization or preventive screen such as a mammogram.

The pilot effort will focus on 1,200 diabetic patients but providers can use the Internet program for all their patients.

After the program ends, it will be evaluated based on a number of factors, including days spent in the hospital, emergency room visits and adherence to medications.

Minier said the medical home approach can curb costs by keeping patients out of the hospital and out of the emergency room.

Medical providers in the pilot program will be eligible to receive incentive payments totalling $3,000 to $5,000 from Blue Cross based on how well their patients' diabetes is managed, Minier said.

Other communities involved are Auburn, Geneva, Grand Island, Lexington, Nebraska City and West Point.

The Blue Cross medical home program is endorsed by such groups as the Nebraska Academy of Family Physicians and the Nebraska Medical Association.

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