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PubMedDate not supplied

Fostering staff ownership of cardiovascular program improvement. Part one: Standardizing care.

This is the first of a two-part series discussing the role that hospital staff play in improving a heart program's ability to compete in the changing heart-services market. It examines the need to provide staff with information about larger, external changes so that there is a basis for understanding why change must occur within the program. Specifically, this first part addresses the role that staff can play in a key competitive strategy: standardization of care. Part Two will outline the importance of providing staff with information and feedback on the impact of their efforts to manage costs and quality.

Cardiology Service, Hospital↗
PubMedDate not supplied

Beware: hospital control or ownership of medical groups.

The rapidly changing, unsettled economic and political health care environment is cause for great anxieties for physicians and hospitals alike. Most physicians have joined IPAs or medical groups in order to obtain continued access to patients who are rapidly shifting from indemnity to cost saving HMOs and PPOs. Many hospitals are seeking to increase their primary care provider base by obtaining control of physicians which may increase their opportunity for institutional success. In many cases, hospitals are providing substantial subsidies or buying physician practices, sometimes in apparent violation of anti-trust law. Physicians ostensibly receive good management advice and infrastructure support from hospital business officers or hospital controlled MSOs. However, when the hospital controls individual physicians or medical groups, there is an inherent conflict of interest because of very different strategic needs. It is not in the physicians' best interests to succumb to the siren songs which hospitals are playing. Providing the highest level of care possible for patients requires that physicians maintain professional independence and autonomy now and in the foreseeable future. Equitable negotiation and collaboration between medical groups and hospitals can only be obtained when there is a lawful and level playing field.

Conflict of Interest↗
PubMed1996

Health systems ownership: can regulation preserve community benefits?

This article addresses two questions. What determines the amount of community benefit a nonprofit firm will provide? What would be the expected effect of legal rules requiring nonprofit firms to provide more community benefit than they would otherwise have chosen? The amount of community benefit provided, it is argued, depends on the desires of the donors who endow the nonprofit firm with its equity capital and control its corporate board. The effect of a law requiring the provision of community benefit depends on the degree of competition in the local market. In competitive markets, such a rule is like a hidden tax. In markets in which nonprofit firms have market power, it may divert resources from types of benefit valued highly by the board toward activities valued highly by the political process. The definition of community benefit and the future of nonprofit hospitals are also discussed.

Community-Institutional Relations↗
PubMed1996

Multi-unit providers survey. A tale of two ownership sectors.

In 1995 investor-owned systems balanced cutbacks and profits, while not-for-profits suffered at the bottom line. Psychiatric hospital systems saw more upheaval, and outpatient and post-acute care grew at a steady pace. And in the senior-living business, the smart money was on assisted living.

Data Collection↗