Columbia watch. Tamer ... not timid.
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Biomedical subjects
Publications and source records attributed to M B Blecher.
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Health care is already feeling the fallout from the 1997 balanced budget pact. And the accord's $100 billion in Medicare cuts, spread over five years, are only beginning to take effect. H&HN looks at two especially hard-hit sectors: home health agencies and rural hospitals.
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Hospital mergers, like Godzilla's comeback movie, promise that bulk means marketplace brawn. Yet as the dust settles, the payoff isn't always so clear. Promised efficiencies from merging duplicated programs--even shutting down entire hospitals--often fail to materialize. In fact, cutting the deal may turn out to be the easy part.
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Thomas Frist worked up a familiar formula for ailing Columbia/HCA, opting to spin off one-third of its hospitals. The change promises Columbia and its offspring more capital and management scrutiny, but the recovery isn't complete.
Drawn by rates only slightly higher than traditional HMOs, consumers have hurried to sign up for open-access plans. Yet what works for patients may work against doctors who assume the financial risks.
Whoosh! That's the sound of once high-flying health care stocks going up in flames. Oxford Health Plans, Columbia/HCA, PacifiCare, MedPartners, and other notables had a rough year--and they're hardly out of trouble yet. In the aftermath, analysts expect major strategic retrenching.
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Healing herbs and alternative therapies already represent a market as big as $40 billion a year--with consumers paying most of the tab. That's why hospitals and entrepreneurs aren't waiting for insurers to expand coverage before venturing into alternative medicine.