What UPMC affiliation has meant for two Pittsburgh-area hospitals - GoErie.com

Published: October 03. 2010 12:01AMPITTSBURGH -- Phil Pollice, M.D., understands what Hamot Health Foundation's soon-to-be-former neurosurgeons are going through.
The five physicians with Tri State Neurological Surgeons are leaving Hamot later this year to work at Saint Vincent Health Center.
They are switching hospitals for several reasons, Tri State President Brian Dalton, M.D., said. One of their concerns is the effect of Hamot's ongoing affiliation talks with the University of Pittsburgh Medical Center.
Pollice, an ear, nose and throat specialist, had just started treating patients at Passavant Hospital in suburban Pittsburgh when it affiliated with UPMC in 1997.
He had no idea what to expect. Some of his fellow Passavant physicians left the hospital before the affiliation took effect.
"There was a lot of fear among the physicians," Pollice said. "The fear was that we were going to be phased out and replaced with UPMC-employed physicians."
Thirteen years later, Pollice is still treating patients as a private physician at UPMC Passavant and UPMC Mercy. He estimated that about half of UPMC Passavant's doctors remain in private practice.
He recently visited Erie to talk with Hamot doctors about what they could expect if Hamot affiliates with UPMC.
"Like I tell people, some doctors did better when UPMC came in," Pollice said. "Others did worse and moved on."
Doctors aren't the only people concerned about Hamot's possible affiliation with UPMC.
Patients are worried they will be sent to Pittsburgh for procedures and surgeries they now undergo at Hamot.
Erie County Executive Barry Grossman has said he fears that Hamot -- Erie County's second-largest employer -- will slash jobs after affiliating with UPMC.
Neither of those scenarios are going to happen, said Liz Concordia, UPMC executive vice president and president of the health system's hospital and community-services division.
"We're looking to invest $300 million in Erie," Concordia said, referring to the amount of money UPMC will give Hamot over the next 10 years if the two health systems affiliate. "So we want Hamot to be successful. We want to bring patients to Erie."
Sending large numbers of patients to Pittsburgh isn't an option simply because there isn't room for them, Concordia said. Most of the UPMC hospitals in Pittsburgh have occupancy rates of more than 90 percent, she said.
"Our hospitals in Pittsburgh are full," Concordia said. "It's to our advantage to have patients stay in Erie, instead of coming down here where there aren't enough beds already."
UPMC plans to do that by sending physician specialists to Erie who will treat patients and perform surgeries currently not done at Hamot.
For example, Hamot cardiologists told Concordia during her visit to Erie that they would like to see a heart surgeon at Hamot who could perform minimally invasive heart-valve surgeries.
"Those surgeries are currently sent to the Cleveland Clinic," Concordia said. "Our goal would be to help Hamot recruit someone to do that surgery in Erie."
As for jobs, UPMC officials are adamant that an affiliation will not result in significant job losses at Hamot, either immediately after an agreement is reached or several years afterward.
"Overall, our history has been net growth in full-time jobs for the hospitals who have affiliated with us," Concordia said. "We tend to see less growth in low-paid back-office jobs and more growth in high-paid clinical jobs."


Concordia pointed to UPMC Passavant and UPMC Shadyside as affiliation success stories.
Both hospitals joined UPMC in 1997. Passavant, located just north of Pittsburgh in McCandless Township, was a 240-bed community hospital that had just begun performing heart surgeries when it joined UPMC.
Shadyside, located in eastern Pittsburgh and one of the city's oldest hospitals, was a 300-bed facility that opened in 1866.
Since affiliating with UPMC, both hospitals have increased by more than 100 beds and hired additional staff, Concordia said. The number of full-time workers has risen by 38 percent at Shadyside and by 79 percent at Passavant.
"Being affiliated with UPMC has really helped us recruit new physicians," said Joel Weinberg, M.D., a UPMC Shadyside pulmonary critical-care physician. "For whatever reason, being part of UPMC is the biggest aphrodisiac to physicians."
One reason could be UPMC's willingness to pump money into each hospital.
The health system has spent $359 million at Shadyside since 2001 and an additional $283 million at Passavant to build cancer centers, expand emergency departments and purchase state-of-the-art diagnostic and surgical equipment.
"Before we affiliated with UPMC, we were a nice, strong community hospital," UPMC Passavant President Terri Petrick said. "Now, we draw patients from a much larger area. We see patients from West Virginia and all along the Interstate 79 corridor."


Not all UPMC hospitals have shared Passavant's and Shadyside's success.
UPMC Braddock closed Jan. 31, almost 14 years after the eastern suburban Pittsburgh hospital merged with UPMC. The hospital had lost more than $27 million over the previous six years.
"There was too much redundancy in terms of service with other hospitals close by," Pollice said. "It's always hard to see a regional community hospital close, but it was the right decision."
UPMC decided in 2008 to convert its financially struggling South Side Hospital into an outpatient center. The urban hospital, which opened in the 1890s, had lost $4 million in operating and total income in fiscal 2008.
In 2005, UPMC sold its Lee Regional Hospital in Johnstown to the rival Conemaugh Health System.
UPMC merged with Lee Memorial in 1998, but couldn't help the 249-bed hospital make money. It sold Lee Memorial to Conemaugh in 2005 for $58 million.
Hamot Chief Executive John Malone said he is aware of how those hospitals have performed but isn't worried that Hamot will suffer their fate.
"Those hospitals had significant problems and issues that Hamot simply doesn't have," Malone said. "Keep in mind that there have also been examples like UPMC Mercy, which was on the verge of bankruptcy and UPMC turned its finances around dramatically."
Mercy Hospital, which opened in 1847 and is Pittsburgh's oldest hospital, merged with UPMC in 2006. It is losing money but has seen its revenue from treating patients increase by 3.2 percent since the merger; operating costs have risen by just 1.17 percent.

Highmark questions affiliation
One of the affiliation's loudest critics has been Highmark Blue Cross Blue Shield, western Pennsylvania's largest commercial health insurer.
Highmark recently placed advertisements in the Erie Times-News and sent letters to local insurance agents questioning the need for the affiliation and what effect it could have on the cost of health care in Erie.
"Our concern is that this affiliation will cause the cost of health care in northwestern Pennsylvania to increase because more people will be sent out of town for treatment," said Dan O'Malley, Highmark's market president of the western region. "We've had a lot of experience with UPMC throughout western Pennsylvania, and the result of these affiliations is often higher costs. Not all the time, but it has happened."
Malone called Highmark's comments "disingenuous."
"One of their claims is that we didn't spend enough time looking at alternatives," Malone said. "One of the alternatives we did look at was partnering with Highmark. We had a meeting and asked them to put some meat on the bones of their proposal, and they came back to us and said they couldn't go through with it for several reasons."
The truth, Malone said, is that Highmark fears an affiliation between Hamot and UPMC will strengthen UPMC Health Plan. Highmark currently has about 63 percent of the commercial health insurance market in Erie County, compared with 4 percent for UPMC Health Plan.
Hamot employees and their families could switch their health insurance from Highmark to UPMC Health Plan if the affiliation is approved. That's about 9,000 covered lives, Malone said.
"That would give UPMC Health Plan a foot in the door," said Martin Gaynor, a professor of economics and public policy at Carnegie Mellon University. "It could enable them to compete with Highmark for folks who are not Hamot employees."


Hamot and UPMC have reached a tentative affiliation agreement and are currently examining each other's finances.
A formal agreement should be finished by December, Malone said. It will then need to be approved by the boards of trustees at both UPMC and Hamot before an affiliation could take effect.
"I believe this affiliation will strengthen Hamot as the area's premier tertiary health-care provider," Concordia said. "For us, it gives UPMC an anchor at the other end of the state, so that patients in your area will go to Hamot instead of going across state lines to hospitals in Ohio and New York state."
DAVID BRUCE can be reached at 870-1736 or by e-mail.

View the original article here

VIDEO/PHOTOS The Alex Sink story: Humble start, business career, Florida governor? - Naples Daily News

Photo by LEXEY SWALL // Buy this photo

Chief Financial Officer for the State of Florida and Democratic candidate for Florida governor Alex Sink, center, is swarmed by journalists asking questions about the race for governor as she leaves the Cabinet meeting Tuesday, September 28, 2010 in Tallahassee. Lexey Swall/Staff

“I never in my life thought I would be a candidate,” Sink said in an interview with the Daily News. “I’ve always been interested in policy and the political process, and I’ve just been one of those who have supported my favorite candidates.”

TALLAHASSEE — This candidate has humble beginnings.

Coming up from nothing, with a family that struggled to balance the checkbooks, finally reaching the top of the business world, now the candidate wants to be Florida’s next governor.

By now, a lot of voters probably recognize that narrative as belonging to Republican candidate Rick Scott, but it turns out his Democratic rival, Alex Sink, shares a similar story of hard work and hitting the big time.

But while Sink, 62, the state’s current Chief Financial Officer, is working to make herself visible through statewide television commercials, many people are still in the dark about who she is.

“In Florida, we generally don’t know much about Cabinet-level officials when they’re in office, except for the governor,” said Daniel Smith, a University of Florida political science professor who specializes in elections. “Alex Sink is a newcomer to politics. She’s not a newcomer to the political scene, however, with her husband having run for governor himself in 2002.”

Her husband, Bill McBride, a Tampa attorney, lost a bid for governor to Jeb Bush, who won a second term in 2002.

Smith points to polls showing that some voters don’t even know whether Sink is a man or a woman. Alex is short for Adelaide, and for the record, yes, she is a woman.

Not just that, but if elected, she would be Florida’s first-ever female governor.

“I never in my life thought I would be a candidate,” Sink said in an interview with the Daily News. “I’ve always been interested in policy and the political process, and I’ve just been one of those who have supported my favorite candidates.”

* * * * *

Alex Sink was born in Mount Airy, N.C., where she grew up on the family farm. The Sink family grew corn, tobacco and soybeans, and raised hogs and cattle — “whatever my dad could make money at,” Sink said.

She attended Wake Forest University, in Winston-Salem, N.C., majored in mathematics, and spent three years teaching in West African schools after graduation.

Together, those experiences of helping her father run the farm and teaching overseas became two of what she calls the most formative experiences of her young life.

Every month, she said, she sat with her father to write checks for the fertilizer bill, the gas bill, the machine shop bill.

Alex Sink Rick Scott Governor of Florida

“Then, he would have me add up all of the checks we had written to make sure we had enough money in the bank,” she said. “I thought I was learning about farming, but what I was really learning, is I was learning about small business.”

Fast forward 40 years or so, and Sink was the bank.

After moving to Florida 26 years ago, she rose to the top position in Bank of America’s Florida operations. She retired from banking roughly 10 years ago, and settled with her family in Thonotosassa, a rural area outside Tampa.

As Chief Financial Officer of the state, she draws a $111,000 annual salary, and in December, she reported her net worth at $9.2 million.

Smith, at the University of Florida, said this part of Sink’s narrative might not ring so true with voters.

“You know, being a millionaire banker is not something that’s going to allow voters to feel warm and fuzzy toward,” Smith said.

Then again, Sink is going up against a self-made businessman who listed more than $200 million in assets at the outset of the campaign.

* * * * *

Sink said she finally considered a run as Chief Financial Officer when several friends approached her five years ago and told her Florida was in desperate need of someone “looking out for our money.”

Much like her rival, Scott, she said she saw problems with the political system in Florida, and wanted to jump in and fix things.

¦ CLICK HERE FOR RELATED PROFILE Rick Scott: Get to work as Florida governor or go home to Naples?

¦ VIDEO Transcript: Daily News interview of Florida governor candidate Rick Scott

Coming from the business world, Sink said she was more than a little surprised to see just how state government runs.

She recalls when a glitch was discovered in the state’s accounting department early in her tenure. She said she asked to see the department’s last audit, in order to find out if the glitch had been caught previously.

It turned out the department hadn’t undergone an audit in 10 years, Sink said.

“Well, coming from a financial background like I did, I was stunned,” she said. “I could not believe there had been so little oversight over a department that, you know, wrote so many checks every year.”

David Clark, who has worked extensively with Sink’s staff as a Cabinet aide in the Department of Environmental Protection, said Sink brings a CEO’s mentality to running the state’s finances. Meanwhile, she has brought together a staff with diverse backgrounds, said Clark, who is set to enter Officer Candidate School with the U.S. Army.

“The staff she has around her epitomize her,” Clark said. “She’s brought in many different types of people from not only the public, but the private sectors, many different realms of business, from finance to communications. She’s surrounded herself with a very diverse group of people and it’s worked well for her.”

Candidate for Florida governor Alex Sink addresses attendees during a town-hall style meeting at the Ritz Carlton in Sarasota, FL. on Thursday, June 17, 2010 at the Florida Society of Newspaper Editors/Florida Press Association annual conference. BRIAN BLANCO/Special to the Daily News

“She really does proscribe to that economic perspective, from the stimulus, health care, these higher taxes, she’s very much in line with Obama, (Speaker of the House Nancy) Pelosi, Washington Democrats,” Scott campaign spokesman Joe Kildea said.

At the same time, said state Rep. Alan Williams, D-Tallahassee, Sink has been able to bridge the gap between Republicans and Democrats. It is something he has seen firsthand, particularly through his work as a ranking member on the Government Operations and Appropriations Committee, he said. It would be an important skill, given the fact that Sink would be working with a Republican-controlled Legislature, if elected.

“On a number of occasions, CFO Sink brought proposals to the table that Republicans supported,” he said.

It is this sensibility — an eye for business and a dexterity in state politics — that Sink promises to bring to bear if she is elected governor.

However, it is Sink’s experience in state government that Scott’s campaign wants to use against her. While it is hard to describe Sink as a career politician — a label that doomed Florida Attorney General Bill McCollum, Scott’s opponent in the Republican primary — the Scott campaign is trying to tag her as a longtime insider who is in lock-step with President Barack Obama.

“She really does proscribe to that economic perspective, from the stimulus, health care, these higher taxes, she’s very much in line with Obama, (Speaker of the House Nancy) Pelosi, Washington Democrats,” Scott campaign spokesman Joe Kildea said.

In order to connect with independents and moderates, the Scott campaign believes Sink is trying to distance herself from Obama. She skipped a joint appearance with him at an August fundraiser in Miami. A pledge on her website to “work with President Obama’s administration” on Everglades restoration was changed to “Alex will provide the strong leadership that’s needed to expedite federal approval of restoration projects,” the St. Petersburg Times reported.

AP Photo/ Phil Coale

Republican gubernatorial candidate Bill McCollum, left, and Democratic gubernatorial candidate Alex Sink, attend the opening day ceremonies of the Florida Legislature, Tuesday, March 2, 2010, in Tallahassee, Fla. McCollum is Florida Attorney General and Sink is Florida's chief financial officer.

Sink has tried to turn around those efforts by Scott’s campaign, firing back with her own commercial accusing Scott of being fixated on Obama.

“You know what I’m doing? I’m running to be the governor of the state of Florida,” she said in an interview. “And so, that’s why when you look on my website, there’s nothing intentional (about the absence of Obama.) ... Florida desperately needs a governor that’s going to attack our Florida challenges, and think about Florida solutions as opposed to a candidate who seems to be obsessed just by Washington.”

* * * * *

Meanwhile, Sink’s campaign wants to frame her as one of the good guys who already came into state government as an outsider, and managed to shake things up.

They tout accomplishments such as her office’s shut-down of an annuity fraud scam that returned more than $1.2 million to seniors. As part of the same Safeguard Our Seniors initiative, she pushed for the passage of bipartisan legislation that would increase penalties for people convicted of annuity fraud.

And having a spouse who ran for state office — the same state office she is seeking — has some benefits, too.

Democrat gubernatorial hopeful Alex Sink, left, and her husband Bill McBride walk in the rain after voting in the state primary election Tuesday morning, Aug 24, 2010 in Thonotosassa, Fla. (AP Photo/Steve Nesius)

“Neither of us had ever run for office, and we sort of created that (2002) campaign at our kitchen table, literally,” her husband said. “Alex was very involved in that campaign. She saw the mistakes — and the good things, too.”

But, McBride also paints his wife as a systematic planner, and someone who makes things happen for herself.

“Her style is very collaborative,” he said. “She seeks a lot of information and a lot of opinions. A lot of collaborative people like that aren’t decisive. But, once she gets all of that information, she’ll make a decision and she’ll move forward.”

At the same time, Sink is still getting the hang of the politics game, it seems. While adept at taking questions in a structured setting, she falters a bit more amid a gaggle of reporters following a Cabinet meeting or press conference. She is still learning the political art of walking and talking, dealing with an onslaught of questions while being ferried from meeting to meeting.

At a press conference inside a Tallahassee job placement firm Tuesday, Sink arrived on a tight schedule between meetings to talk up her plan for tax breaks to new businesses and strengthening education to create more competent graduates. Workforce Plus, a job placement firm, sits in a run-down strip mall two miles outside downtown Tallahassee, where job applicants looking for work line the waiting room chairs.

Sink bypassed the job seekers without a word or a handshake, heading for the room with the television cameras and Republican state Sen. Alex Villalobos, who endorsed Sink the day before. She talked up her plans, before heading back out the door, again passing by the people she is promising to help.

But in an election season in which both candidates admit jobs are the top issue, and polls vary on whether Sink or Scott is ahead, every vote is going to count. It is a race that could turn out to be a matter of who you know, or rather, how well you know a candidate.

* * * *

Staff writer Ryan Mills contributed to this report

Primary Election Coverage:

Elections 2010 Page:

View the original article here

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)

View the original article here