Beyond four walls. CEOs break new ground as community leaders.
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Biomedical subjects
Publications and source records attributed to K Lumsdon.
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New technologies are rapidly transforming hospital surgery, shifting a majority of procedures to outpatient settings and cutting stays for inpatients. This shift is forcing hospitals to re-evaluate physician privileging, surgical staffing and scheduling, facility planning and strategic planning. Meanwhile, the Health Care Financing Administration's efforts to reform Medicare's payment system for outpatient surgery and other ambulatory procedures is on a slower track.
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While construction budgets appear to be tighter in the wake of Medicare's fold-in of inpatient capital payment, hospitals are going ahead with ambitious plans for expansion and renovation. But construction planning is increasingly becoming more interwined with overall strategic planning.
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Genetically engineered human insulin received federal approval nearly 10 years ago, but the pace of federal approval for new biotechnology drugs remains painstakingly slow. In any case, hospitals will soon face a multitude of financial, ethical and procedural issues surrounding these drugs.
The rules governing home health care are confusing, contradictory and expensive, say providers, and they're getting more so. But that doesn't mean the rules should be made lax, they argue. Some even look forward to quality enhancement as a by-product of new "outcome-oriented" Medicare surveys. Inevitably, home health care administrators agree, increased federal scrutiny has likely been spurred by the massive growth in the field in the past 15 years.
With legislative and regulatory scrutiny trained on not-for-profit hospitals, administrators should brace themselves for potential challenges to their tax-exempt status. Industry leaders recommend reviewing documents that outline a hospital's charitable purpose, setting a clear policy on providing care to persons unable to pay for it, placing a value on community services, and taking other steps. Whether changes in laws governing tax exemption come from national, state, or local efforts, hospitals should be ready to show proof of their charitable activities.
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