PRIVATE HEALTHCARE CENTRAL
November 14, 2006-- TOP STORY: THE NEW CONGRESSIONAL HEALTHCARE LEADERSHIP
-- LOCAL ISSUES: NEW MEDICAL OFFICE BUILDINGS STILL IN THE WORKS
-- EDITORIAL: WE’RE JUST ANOTHER SEAT AT THE BARGAINING TABLE
-- MEMBER NEWS: 64 SLICE CT CORONARY ANGIOGRAPHY NOW AVAILABLE AT PARKVIEW IMAGING
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| TOP STORY: THE NEW CONGRESSIONAL HEALTHCARE LEADERSHIP There are big changes coming in the political debate about the future of U.S. healthcare. Those framing the debate in Congress will soon shift to new voices representing some of the oldest foes of private healthcare. Senator Ted Kennedy will chair the Senate’s Health, Education, Labor and Pensions(HELP) Committee. He is a fervent proponent of S-CHP which seeks to enroll millions of children in Medicaid. He supports government price controls for drug formularies in Medicare Part D. He is also a staunch opponent of health savings accounts. Representative Pete Stark will head the Health Subcommittee of the House Ways and Means Committee. He recently stated that his top priority is to stop “the Republican drive to privatize Medicare.” He supports government price controls for Medicare Part D. He is another opponent of HSAs. His name is attached to some of the most onerous regulations on the business practices of physicians Reprentative John Dingell will chair the House Energy and Commerce Committee with jurisdiction over Medicaid and other healthcare isssues. He is expected to launch investigations of health insurance companies, the hospital industry and pharmaceutical industry. The recent snowball effect on consumer driven healthcare created by employers embracing HSAs may stall or melt completely. Kennedy, Stark, Dingell and others will shift the debate from marketplace consumerism solutions back to government regulation and beaurocracy. It is also much less likely that the 5% Medicare reduction for 2007 will be reversed and that future reductions can be avoided. If so, the pace of the Medicare collapse will quicken. Will you be a Medicare participant in 5 years? Will you opt out? Will you transition to a retainer practice? Will you look for more ancillary services to add to your bottom line? The answers to these questions may be largely determined by the actions of the new congressional healthcare leadership.
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| LOCAL ISSUES: NEW MEDICAL OFFICE BUILDINGS STILL IN THE WORKS A new medical office complex nearby could significantly impact our marketplace if populated by outreach programs or physicians from UCLA, the Cedars community or elsewhere. The much delayed Stonebridge Holdings project is still moving forward and the plans include 200,000 ft of medical space in 2 eight story buildings. The developer, Michael Lombardi, has presented this project to APPA twice in the past 4 years. It is located at Olympic and Bundy. Initially it was to house a new hospital, but the Tenet implosion and new limits on specialty hospital growth quashed that idea. It is now called “Bundy Village and Medical Park”. It contains 125,000 feet of commercial space, a retail mall and 385 condo units built above the mall. A large portion of these units will be for senior housing. The developer is in discussions with nearby hospitals, radiology/imaging enterprises and physician groups. APPA will keep you posted.
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| EDITORIAL: WE’RE JUST ANOTHER SEAT AT THE BARGAINING TABLE I was talking with one of our more prominent members recently who made a very prescient statement: “You know, there are a lot of new faces around the hospital, a lot of doctors we don’t know.” I had not thought about this specifically, but the implications of this remark were immediately obvious to me. All of the recent hospital initiatives to bring in new specialists have populated the hallways with doctors largely from outside our community. Almost none of them are known to us and surely very few understand or care about the private healthcare community represented by APPA. These groups include the new orthopedists, their new hospitalists, and their fellows in training. Several of the larger established groups have added new younger faces to their rosters. The newly cemented relationship with the John Wayne Cancer Institute and its evolving faculty and fellows could be added to this list. We are led to believe that there are more to come. Most of this represents the hospital’s destination healthcare strategy designed to bring in business from outside its current marketplace. As such, it is a unique book of business for the hospital’s administration to deal with. Another “book” is composed of the larger specialty groups: orthopedics, cardiology and primary care/managed care. With 10-20 physicians, these groups function very differently than those of us practicing relationship based, patient centered care. Yet, because of their size, their potential impact on the hospital’s outpatient business revenues can be great. They are another important category of the medical staff for administrators to negotiate with. All of those listed above are larger corporate entities. They have the economy of scale, infrastructure, administrative support and available time to successfully represent their agendas regarding hospital issues. Individually, the members of APPA have none of these advantages. We may be much larger in number, but we do not (yet) think of ourselves as committed to a single common agenda of business goals. This represents a real disadvantage when negotiating with a formidable entity such as a hospital. Whether we are confronting our local hospitals, CMS/Medicare, organized medicine or the political process, we are just another seat at the table. We would be well advised to organize ourselves as effectively and invest our time and money as much as those in the seats around us. That is one man’s opinion. I look forward to hearing yours. ---Richard L. Taw Jr., M.D.
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| MEMBER NEWS: 64 SLICE CT CORONARY ANGIOGRAPHY NOW AVAILABLE AT PARKVIEW IMAGING APPA member Jerry Dalrymple, MD reports that Parkview Imaging is now performing coronary calcification scoring and CT coronary angiography with its "64 Slice" Helical CT (Toshiba). The scanner is capable of creating 64, 0.5mm slices in each 360 degree tube rotation (1 second). Volumetric acquisition of the heart scan data is achieved in 8-10 seconds, an easy breath-hold for patients. The entire exam is performed in under 30 minutes utilizing the IV injection of contrast. Volume rendered angiographic images are approaching the spatial resolution of catheter angiography. The negative predictive value of CT coronary angiography is over 95%. Currently, Medicare does not reimburse for this exam, although reportedly it will be in the near future. The cash price is $1200 See our web site for more detailed information (www.parkviewimaging.com). Private Healthcare Central is a publication of the American Private Physicians Association. Direct comments or questions to Pamela Deloney, administrator for APPA.
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