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From page 543... ... Index A Abbott Laboratories, home health care services, 35 Accelerated Cost Recovery System, 54, 65-66, 90, 509 Access to care, see Health care, access to Adventist Health Systems, 29, 41 Aid, Inc., 253, 502 Alcohol treatment centers, 42, 100 Ambulatory care centers access to care through, 189, 226 characteristics, 35-36 charges, 91 competitive basis of, 94 cost savings through, 186 for-proBt, 36-37 growth trends, 36-3`, 226 innovations by, 91 ownership of, 26, 30-36, 40, 91 see also Birthing centers; Dialysis treatment centers; Primary/urgent care centers Ambulatory surgery centers characteristics, 35-36 design innovations, 41 equity investment in, 43 for-profit, 36 growth trends in, 36, 226 hospital-affiliated, 36 independent, 36 innovations by, 91 number of, 36 operations performed in, 36 American College of Physicians code of ethics, 161 American Health Capital, Inc., 43 American Healthcare Systems, 10, 29, 43, 503 American Hospital Association data on uncompensated care, 101-102 American Hospital Supply Corporation, 16 American Medical Affiliates, 502 American Medical Association code of edhics, 152, 153-154, 161, 166, 167, 213 policy on physician conflict of interest, 159 political role of, 241 American Medical International growth trends, 109-110, 251-253, 256-257 health maintenance plan, 144 home health care services, 35 number of beds, 252, 474 number of hospitals, 44, 250,474 nursing home ownership, 502 previous ownership of hospitals acquired by, 254, 255 tax obligations and payments, 53 teaching hospital acquisitions, 144 uncompensated care by, 114 American Medical Services, 503 American Medicorp, 251 Americana, 502 Anesthesiologists Board certification of, 131 compensation of, 166, 395, 429, 431, 452, 455 distribution by hospital ownership, 388 Angell Group, 503 ANTA, 502, 503, 509 AFUt Living Centers, 33, 501-503, 520 Associated Health Systems, 41 B Bad debt, see Health care, uncompensated Baxter Travenol Laboratories, 16, 35 Beds banking of, 307 excess of, 49-50, 64, 135, 187 investor-owned, 28, 30, 32, 80, 202, 250, 475 medical residents per, 142. 143 not-for-prof~t number, 29, 30, 32 543 Read the entire page →
From page 544... ... 34 Cisil Rights Ounce, data on uninsured patients, 100 101 188 INDEX Clinics, ownership of, 40 Colorado corporate practice of medicine in, 166 financing uncompensated eare in, 119 Community Dialysis Centers, Ine., 38 Community Hospital of Sacramento, 2.53 Community Psychiatric Centers, 32 CompCare behavioral medicine hospital ownership, Comprehensive Care Corporation, 43 Connecticut, nursing home patient discrimination in, 118 Continental Care Centers, .502 Convalescent Serviees, .503 Corporate practice of medicine, 166, 174 Cost-based reimbursement, 50, 51, 56-57, 75, 77, 87, 94-95, 99, 156, 329, 498 Costs, see Finaneial capital, costs; Health care, costs; Hospitals, costs; Multihospital systems, costs; ^Nllrs~ng homes, costs D Debt financing, 54-55, 58-61, 71, 477 Dentists on hospital payrolls, 429, 4.51 Diagnostic centers, 38, 40 Diagnostic Centers, Inc., 38 Dialysis Clinics, Inc., 38 Dialysis treatment centers, 26, 38-40, 93-94 Doetor's Off~eenters, 37 E Eeonomic Beeoverv Tax Aet, 509 Eeonomic theories about health eare organizations, 5, 7, 19-~.5 Education, medical cross-subsidization of, 228-229, 24.5, 248 effects of investor ownership on, 142-150, 190-191, 245-246, 248, 2~6, 397 hospital commitment toward, 26.5, 273-276, 279280, 282, 285-987 public benefits of, 246 Equity financing, 41, 42, .50-51, 61-62, 67-73 Extendieare, 502 Federal Deficit Reduction Aet of 1984, 160 Federal Housing Administration 242 program, 59 Finaneial capital access to, 34, 47-50, 60-69, 65, 67, 184, 196, 283, 508 costs, 47, 56-57, .59-62, 64, 80, 197 earnings, 50, 57, 61 for-prof~t sources, 6, 9, 61, 477 from ~leclicare pay meets, .51, 64, 65, 140 future needs for hospitals, 49 government sources, 50, 57 grants, 50, 54-55. Read the entire page →
From page 545... ... INDEX hospital requirements, 23, 49, 477 interest expenses, 50, 59 investment incentives, 52-53, 62 investor equity, 51, 61-62, 67-73, 191 nature and importance of, 47-73 not-for-profit sources, 6, 9, 61, 62, 64, 477 operating revenues, 50, 262-264, 273-277, 287 philanthropic, 50, 54-55, 57, 59-60, 63, 99, 118119, 184 policy issues regarding, 64-65, 196-197 return-on-equity payments, 50-51, 62, 65 sale of debt instruments, 50, 60, 67; see also Debt ~ . rlnancmg sources for health care organizations, 6, 9, 26, 43, 50-59, 61-65, 184, 201, 218, 218 tax deferral, 53-54, 62, 63 uses, 50-52, 119 working, of HMOs, 48 Finland, hospital ownership and financing in, 57 First Healthcare Corporation, 502 Florida costs of hospital care in, 481-483 hospital acquisitions in, 88, 105, 202, 303-321 hospital emergency rooms in, 109 hospital margins on revenues in, 328 uncompensated care in, 102-103, 105, 119, 188, 202, 319 Forum Group of Indianapolis, 144 Four Seasons Nursing Centers, 500, 502, 503 France, hospital ownership and financing in, 56 Freestanding facilities charges, 106 growth of, 91 hospital competition with, 91, 106-107, 116, 174 multihospital system operation of, 40 ownership, 106, 154-155, 175 quality of care in, 138 services, 106, 154-155 uncompensated care by, 106 see also Alcohol treatment centers; Ambulatory care centers; Ambulatory surgery centers; Birthing centers; Diagnostic centers; Dialysis treatment centers; Primary/urgent care centers G General Care Corporation, 251, 253 General Health Services, Inc., 251, 253 George Washington University Hospital, 144, 145 Geriatrics, 502 Government funding of health care, 11-13, 57 health care organizations, 17, 19, 57 obligations concerning uncompensated care, 113, 110-116, 195, 228, 23o role in health care, 5, 12, 235 stimulation of HMOs, 33 545 subsidization of not-for-prof~t hospitals, 62-63 see also Hospitals, government Group Health Association of Washington, 33 Group Health Cooperative of Puget Sound, 33 GWU Health Plan, 144 H Harvard Community Health Plan balance sheets, 47, 48 flow-of-finds statement, 50-51 Health benefits programs, 27, 41 Health care access to, 97-126, 18(-189, 225-232 amenities, 13, 107, 236 as a commodity, 11-12, 14-15, 183, 220, 233-237, 244 as a social good, 12-15, 182-183, 220 conflicts of interest in, 15, 152, 158-161, 163-164, 197, 214, 217, 219, 237-245, 248, 396 consolidation of providers, 43 costs control of, 91 data sources on, 92-93 definition and measurement of, 74-76 distribution of, 209-210, 213, 210, 220, 228, 230, 231, 247 effect of for-pro~t health services on, 93-94 effect of investor-owned hospital systems on, 480-483 findings about, 185-187 for capital, 47, 51, 56-57, 59-62, 64, 68-69, 71 ,2, 80, 197 hospital post-acquisition increases in, 87, 480 481 measures of, 261-264 monitoring trends in, 92-93 recovery of, 98-99, 113 savings through ambulatory care centers, 186 to community, 80-81, 84, 94 see also Hospitals, costs; Nursing homes, costs data sources on, 92-93, 101-102, 188, 261, 262, 285-286, 403, 422-423 economic incentives in, 192-193 entry barriers, 22, 23, 24 ethical issues, 3-4, 11-16, 17, 111-116, 151-153, 182-183, 192, 209-249, 396 expenditures, 3, 5, 35, 38 financial capital sources for, 6, 9, 26, 43, 50-59, 61-65, 184, 201, 218, 219 government funding for, 6, 9, 11-13, 55 government role in, 5, 12, 235 growth trends, 3, 26-29, 31-38, 47-73, 88, 90-91, 108, 190, 226, 250-259, 290, 292-294 information asymmetry in, 13, 20-21, 23-24, 139 140, 236-237 insurance effects on, 11 key elements of, 13 Read the entire page →
From page 546... ... 185-187 quality effects of in`,estor-owned multihospital systems on, 37~-376, 483-487 for-profit status and, 90, 127-141 in freestanding facilities, 138 in hospitals 127-134, 189-190 in not-for-profit organizations, 92 in nursing hones, 131-137, 140, 510-521, 530 531 indicators of, 127-134, 139, 189-190, 376, 487, 515, 519 monitoring, 92-93, 112, 137-139, 156, 190, 199 900 outcome measures of, 133-135, 139, 520 patient judgment of, 13 physician evaluations of, 130-132, 189, 396-397, 399 physician responsibility, 15, 171-174, 237-245 refusal for financial reasons, 98 regulation of, 12, 26-27, 135-136, 242, 246-247, 272-273, 078, 280-981, 284, 286 sectors, 19' 24 services configuration and control changes, 26~6 new, 38-39, 64 outside of hospitals, 27 pricing of, 13, 74-76, 80, 87, 185-186, 277, 287, 994-296 unnecessary, 13, 17, 158-160 vertical integration of, 39-41 see also Hospitals, services structural changes in, 26-46, 92, 260 I.\'DEX tar subsidization of. 903 trends in. Read the entire page →
From page 547... ... INDEX access to capital by, 34, 47-50, 60-62, 65, 67, 184, 196, 283, 508 assets, 47-49, 52-53 behavior of, 5-6, 9-11, 13-14, 20-23, 93, 260-289 combined provider/insurance functions of, 44 competition between for-profit and not-for-profit, 117-118, 183, 232-233, 247-248, 265, 270, 2~2-275, 278, 280-281, 284, 462~64 constraints on, 10-11, 88, 137 credit ratings of, 61 debt financing by, 10, 50, 54-55, 58-65, 67, 71, 184 definitions of, 16 distinctions between for-profit and not-for-prof~t, 5-11, 86, 184-185 diversification by, 39-42, 44 earnings, 50 economic theories about, 5-6, 19-25 efficiency of, 9, 16, 22-24, 75, 186-187, 225, 296, 312, 317-318 expense types, 74 government capital sources for, 57 characteristics, 17 economic rationale for, 19 growth of, 3, 26-38, 47-73, 88, 90-91, 108, 190, 226, 250-259, 290, 292-294 hybridization of for-prof~t and not-for-prof~t, 10, 26, 41-43, 44 incentive bonus arrangements with physicians, 153, 156-107 investor-owned, 3-10 access to care under, 97-126, 225-232 advantages and disadvantages of, 3-4, 97, 187, 226 concerns about, 4, 13, 97-126, 187, 225, 232 efficiency of, 23-24, 75, 18~187, 225 management of, ~7, 16, 23 mission, 6, 60 physician exit and voice mechanisms in, 176-178 profit distribution, 6, 184 profitability incentives, 7, 184-185 rationale for, 21 research activities of, 148 revenue sources, 6, 52 social obligations, 226-230 stool; options, 16-17 subsidization of health care, 227 taxes, 6, 227 types, 183 legal differences in, 184 legal responsibilities of, 98, 112-115, 117, 228 management contract arrangements among, 40-42, 255-256, 271-2-15, 278, 280-281, 284, 286 new types of, 35-39 not-for-profit, 6-10 advantages of, 8, 62-63 547 capital sources, 6, 61, 62, 64 characteristics, 7-8, 232-233 corporate reorganization of, 184 efficiency, 9, 22, 75, 186-181 financing, 8, 10, 17, 62-63 future of, 194 goals and ideals, 8, 75 investment in unneeded equipment and facilities, 9, 22 management of, 6, 22-24 mission, 6, 60 nondistribution requirement, 6, 7-8, 10, 20-21, 75, 184 protection of from competition, 232-233 purposes, 6, 8, 22 quality of, 22 rationale for, 20 revenue sources, 6, 20, 24 tax status, 6, 8, 10, 20, 63, 98, 113-115, 184, 227, 233 tax-exempt bond funding by, 10, 55, 59-60, 62 65,67,81, 184, 197 obligations to provide uncompensated care, 98, 112-115, 117, 228 ownership diversity, 4-5, 16 physician investment in, 153-156, 159, 162-163, 197-198 physician relationship with, 10-11, 15-16, 24 social responsibilities of, 97, 113, 193-194 tax obligations and payments, 53-54, 62, 193-194 Health Care Retirement, 503 Health Central Corporation, 41 Health Insurance Plan of Greater New York, 33 Health Maintenance Organization Act of 1973, 33 Health maintenance organizations, 33-34 balance sheets, 47-49 Blue Cross/Blue Shield, 44 bonus incentive arrangements in, 158, 238 flow-of-funds statement, 50, 51 hospital use rates of, 159 limitation on care by, 238 Medicare market for, 34 multihospital system operation of, 40, 41 multistate, 34, 44 negative aspects of, 219, 238 ownership of, 26, 40 Health Resources Corporation, Inc., 39, 253 Health status indices, 139 Health Ventures, 42 Hill-Burton program, 59, 98, 117 Hillhaven nursing homes operations, 33, 501-503, 509, 520 Home health care, 26-2~, 34-35, 40, 138, 159 Horizon Health. 253 Hospice Care, Inc., 39 Hospice care, 38-39, 121 Hospital Affiliates International, Inc., 87, 251, 253 Read the entire page →
From page 548... ... 287, 365-367, 374, 458-473 certificate of need for, 23 charges, 93. 328, 344-349 chief executive officers, 406-408, 414 chief of staff, 409, 416 closures, 105, 109-110,_56-2~7 community interaction of, 458~73 INDEX compensation methods, 393-397 competition between, 117-118, 265, 270, 272-275, 278, 280-281, 284, 462-464 competition with ambulatory care facilities, 91, 106-107, 116, 174, 462, 464 construction trends, 28, 251-253 construction, funding for, 54-55, 57-59, 119 contract management of, 40-42, 255-256, 271-275, 278, 280-281, 284, 286 corporate restructuring of, 41, 307 cost containment committee, 407, 409, 419 costs administrative, 273, 277 allocation methods, 75, 77, 94, 95 data sources on, 323 educational, 119 incurred under diagnostic-related group, 40 input, 265, 272, 279, 282, 285 measures of, 261-264 medical education, 287 of acquisitions, 80, 87-89, 186, 319-320 of care in, 480-483 of equipment, 119 operating, 290 regression analyses of, 322-353 reimbursement for, 56-57 research, 119 cross-subsidization by, 99, 106-107, 312 data sources on, 261, 262 decision making in, 171-172, 175-178, 402-421 director of medical education, 408, 417 discharge information on basis of ownership, 340 343 diversification by, 42, 44, 464 divestitures by investor-owned hospital companies, 256-257 drug utilization review by, 380 dumping of patients by, 104, 119 economic performance factors, 26.5 effect on competitive climate of communities, 462 464 efficiency post-acquisition, 317-318 efficiency pre-acquisition, 312 evaluation of quality, by physicians, 130-132, 189, O99 expansions, 251-253 expenses administrative, 77 after acquisitions, 87, 317-320 analyses of, 92 average annual rate of increase, 77 categories, 296 depreciation and amortization, 52, 59 for drugs and supplies, 80 occupancy effects on, 77 operating, 77, 296-297, 312 patient care, 186 Read the entire page →
From page 549... ... INDEX personnel-related, 80 studies of, 76-80 facilities emergency room, 104, 105, 107-109, 117, 122, 298, 46~66 pharmacy, 108, 125, 295, 298 premature nursery, 108, 109, 118, 121, 465 financial arrangements with physicians, 393-396 financial screening of patients, 104 functional strategies governing boards, 405-406, 411 governance, physician participation in, 402-421 government capital sources for, 50 construction Finding sources, 59 contract management of, 41 Medi-Cal patients in, 295, 297-298 uncompensated care by, 98, 114 growth in California, 292-294 influence of physicians in, 157, 171-181, 198-199, 470-471 international ownership and financing, 55-57 investor-owned capital sources, 9, 50, 61 cost of equity financing, 51, 61-62 definition, 31, 224 distribution by state, 31 efficiency of, 225 expenses, 76-80 financial strategies, 287, 290-302 grant eligibility of, 142-143 growth rate, 28 lengths of stay, 77, 93, 9S local property taxes, 53 locational preferences of, 86, 103-104, 183-184, 187, 307 market share, 30 medical residency programs in, 142-144 medical staff composition, 389, 400 Medicare capital payments to, 51, 65 number of, 28, 44, 183 patient outcomes in, 140, 367 physician attitudes toward, 394, 396-398 physician involvement with, 386-392 pricing strategies, 287 profitability, 287 quality of care in, 367 research in, 142 response to financial incentives, 29~301 return-on-equity payments, 50-51 revenue sources, 9 size of, 29, 255 tax deferral by, 54, 62 taxes, 119 uncompensated care by, 213, 483 see also Ownership/affiliation comparisons, hospitals 549 joint ventures of, 41, 43, 1~5 leasing arrangements with physicians, 175, 393 legal responsibilities, 98, 105, 117 lengths of stay in, 157, 159, 992, 338-339, 359-363 long-range planning committee, 407, 409, 420 management of by physicians, 406-408 markups, 84, 262, 277-280, 287 Medicaid caseload in, 305, 306, 312, 313, 317 medical education commitment of, 265, 273-276, 279-280, 282, 285-287 medical resident/bed ratio, 142, 143 medical staff applications, 423-42S, 430 committees, 407-409, 418, 420 qualifications, 128-130, 131 salaries and benefits, 80, 312 size and composition, 174, 313, 422-426, 430, 434, 440-445 Medicare capital payments to, 51 Medicare case mix in, 359 membership in alliances, 41 methods for assuring payment, 467 modeling of behavior of on basis of affiliation and ownership, 260-289 monitoring care in, 137-138 monitoring physician patterns of care by, 156 mortality rates by type of, 357-365, 367-368, 371, 273 net margins, 9, 201-202 not-for-prof~t beds, 29, 30, 32 capital, 9, 80 characteristics, 232-733 expenses, 66, 76-77 financial incentives, 290-302 management by investor-owned systems, 41 price differentials between for-profit systems and, 80, 464 protection from for-profit competition, 232-233 response to financial incentives among, 290-303 revenue sources, 9, 42, 66, 93, 233 tax exemptions, 114, 116, 157 uncompensated care by, 98, 114, 116, 225, 228, 232-233, 465-467 nursing support adequacy, 132, 189, 397 obligations to provide uncompensated care, 112 115 occupancy rates, 39-40, 49, 64, 77, 87, 94, 95, 186, 283, 286, 292, 301, 306-307, 312, 326 organizational mission, 354-374 outcomes relative to size of, 359 ownership, 4, 28, 40; see also Ownership/aff~liation comparisons, hospitals patient selection strategies, 262-263, 265, 272-275, 281, 284, 287, 312 payer mix in, 391 pricing Read the entire page →
From page 550... ... actuarial risk assumption by, 41 acute care hospital ownership, 44 balance sheet, 47, 49 capitalized lease arrangements, 258 dividends, 61, 70 flow-of-funds statement, 50, 52 growth trends, 109-110, 250-253, 256-257 interest rates on long-term debt, 61 market effects on facility ownership, 288 mergers, 251 number of hospitals, 250, 474 primary care center ownership, 37-38, 40-41 relationship with Symbion, 149 research grants by, 148 revenue sources and uses, 50, 52 size, 3, 474 stock options, 17, 61 tax obligations and payments, 53 teaching hospital affiliations, 144 uncompensated care by, 114 HumanaCare Plus program, 41 Hyatt, 251 Independent practice associations, 238 Insurance effects on health care market forces, 11 Read the entire page →
From page 551... ... , 144 Minnesota nursing homes admission discrimination in, 118 quality in, 514 Mission Services Corporation, 43 Models competitive market, 19 economic, 19-24 Monterey Life Systems, 502 Multihospital systems access to capital, 61, 477~78 accreditation trends of, 364-367, 375-384 acquisitions of by other chains, 251 administration of hospitals in, 467-470 advantages and disadvantages of affiliation with, 27, 60-61, 375-376, 469-470, 477~80, 486 bond ratings, 60-61, 478 borrowing power, 26, 60, 477 case mix, 368 characteristics of hospitals in, 461470 comparison of investor-owned and not-for-profit, 29-32 compensation arrangements with physicians, 422457 diversification by, 478479 economic benefits of membership in, 477~79 economic perfonnance of hospitals in, 260-289 economies of scale, 287-788 effects of membership in, 467468 investor-owned access to care in, 105-106, 483-486 accreditation status, 367-368 acquisitions, 105-106, 117, 250-256 advantages and disadvantages, 105, 189, 329, 476477 balance sheet, 47, 49 Read the entire page →
From page 552... ... 479433 tax obligations and payments, 53-54, 62, 195 teaching hospitals, 143-149 uncompensated care bv 103 486 ,, , vertical integration of services by, 40 local control in, 61, 467-470 medical staff sizes, 422-457 modeling of behavior of, 260-289 not-for-prof~t beds. 29, 30, 32 capital raising by, 61 corporate restructuring of, 42 diversification by, 40 fornication of, 98-29 geographic distribution of hospitals, 287 government subsidy of, 69-63 investor-owned subsidiaries of, 42 management of for-prof~t hospitals by, 41 management of, 468469 number of hospitals in, 29, 30 religious/secular breakdown, 29 vertical integration of services by, 40 occupancy rates, 39-40, 77, 95 personnel management by, 479 physician privileges, 422-457 planning by, 479 political power of, 479 pricing strategies, 277 quality of care in, 375-377, 483-487 revenue sources, 41 size, 29 types of health services, 26 vertical integration of services by, 39 see also Hospitals; Ownership/aff~liation comparisons N National Association of Private Psychiatric Hospitals, 44 National Health Care Affiliates, 503 National Health Corporation, 503 National Health Enterprises, 502, 507 National Health Planning and Resources Development Act of 1974, 118 National Health Services, 502 National Medical Care, 38 National Medical Enterprises diversification by, 476 educational endowments by, 148 growth trends, 109-110, 250, 252-257 home care enterprises, 35 number of hospitals, 44, 2.50, 474 nursing home operations, 33, 528 psychiatric hospital ownership, 32, 44 revenue sources, 40 tax obligations and payments, 53, 114, 119 teaching hospital construction, 144 uncompensated care by, 114 vertical integration of services by, 40 National Medical Home Care, Inc. Read the entire page →
From page 553... ... S health care organizations, 4-5, 16 freestanding facilities, 106, 154-150, 175 geographic patterns, 183-184 government role in, 5 health care costs on basis of, 74-96, 185-187, 322 353, 480-483 hospitals accreditation trends on basis of, 128-129, 189, 364,367, 374, 378-379, 382-383 activity and productivity on basis of, 283-287 acute care, 28 admissions by sources of payment and, 101 bed capacity on basis of, 30, 32, 80, 250-251, 270, 272-275, 279-280, 282-283, 285 Board chairman responsibilities on basis of, 132 133 Caesarean section rates by, 134-135, 138 capital structure on basis of, 263-264, 280-283, 287 case-mix differences on basis of, 271-278, 281, 283,284, 287, 366-367, 374 case studies of, 458-473 changes in, 305 charge structure according to, 296, 298, 328 closures on basis of, 109-110 comparison of nursing home ownership and, 134, 187 competition on basis of, 265, 270, 272-275, 278, 280-281, 284 conflicts of interests in, 159-160 contract management on basis of, 271-275, 2~8, 280-281, 284, 286 cost comparisons relative to, 322-353 cost-effectiveness on basis of, 290 deductions from revenue on basis of, 297 discharge information on basis of, 340-343 distinctions between, 5-11, 86 Read the entire page →
From page 554... ... 77, 95 medical education implications of, 142-150, 190 191, 245-246, 248, 276 medical residency programs and, 142, 143 multihospital system advantages and disadvantages, 469-470 nursing homes comparison of hospital ownership with, 134 costs by, 89-90, 186, 521 patient discrimination on basis of, 528-529 quality of care on basis of, 136-137, 510-521 physician perspective on, 385~01 physician voice in hospital on basis of, 176-178 primary/urgent care centers, 36-37, 175 relationship to sources of capital, 57-59 research implications of, 142-150, 190-191 types of, 4, 16 uncompensated care on basis of, 97-116, 187-188 213, 225-226, 228, 232-233, 465-467 p Parkside Medical Services Corporation, 42 Pathologists Board certification of, 131 compensation of, 166, 395, 430, 432, 454, 457 distribution by hospital ownership, 388 Patients dumping of, 104 heavy care, 110-111, 118 Medicare in nursing homes, 110, 136 outcomes, 354-376 physician attitudes toward, 14 readmission rates, 134 outcomes 133-134, 135, 354-376 Read the entire page →
From page 555... ... 470-471 in hospital decision making, 24, 174-179, 198, 402, 421 in nursing homes, 135, 137 internal medicine, 388, 395, 426, 434, 443 investments in health care organizations, 153-156, 159, 162-163, 197-198 involvement in for-profit hospitals, 385-401 joint ventures with hospitals, 155-156 laboratory ownership by, 156, 166 laboratory test ordering by, 158-160, 167 leasing arrangements with hospitals, 175 license suspension, 161 locational preferences of, 141-142 medical specialty, 129, 131, 426, 444 and Medicare, 14, 241 moral obligations of, 240-241 OB/GYN, 131, 388, 395 perspective on hospital ownership, 385~01 policy options regarding, 159-165 practice patterns, 385401 preferences in hospitals, 397 public trust in, 151 qualifications of for hospital staff privileges, 128 130, 131 referral and admission patterns, 173-175, 178, 179 refusal to accept patients, 212-213 relationships with health care organizations, 10-11, 15-16, 24 relicensing of, 214 responsibilities to patients, 15-16, 24 responsibility for quality, 171-174, 237-245 self-regulation, 242, 24~247 services, volume of, 14, 156, 158-159, 238 surgical specialty, 129, 131, 388, 434, 445 surplus of, 37 third-party payments to, 14 unionization of, 180 Preferred provider arrangements, 41 Presbyterian-St. Luke's Hospital (Denver) Read the entire page →
From page 556... ... 371-373 sales on 17 Surgicare, Inc., 36 INDEX Sweden, hospital ownership and financing in, 56 Svmbion, 149 T Tax Equity and Fiscal Responsibility Act, 366, 506 Taxes ACES, 54 deferred, 53-54 exemptions from, 6, 8, 66, 113-114, 227 health care subsidization with, 203 investment credits, 509 of investor-owned health care corporations, 53-54 policies relevant to nursing homes, 509-510 Tennessee, uncompensated care in, 102-103 Texas corporate practice of medicine in, 166 Medicaid utilization rate in, 528-529 nursing homes, 508, 517-520, 524-525 uncompensated care in, 102-103, 117 Tulane Hospital (New Orleans) , 144 U Uncompensated care, see Health care, uncompensated Unicare, 502, 503, 509 Unifour Medical Management, 503 United Healthcare Corporation, 34 United Kingdom, hospital ownership and financing in, 56 University of Mississippi Hospital, 144 Upjohn Health Care Services, 35 U.S. Read the entire page →

From page 543...

... Index A Abbott Laboratories, home health care services, 35 Accelerated Cost Recovery System, 54, 65-66, 90, 509 Access to care, see Health care, access to Adventist Health Systems, 29, 41 Aid, Inc., 253, 502 Alcohol treatment centers, 42, 100 Ambulatory care centers access to care through, 189, 226 characteristics, 35-36 charges, 91 competitive basis of, 94 cost savings through, 186 for-proBt, 36-37 growth trends, 36-3`, 226 innovations by, 91 ownership of, 26, 30-36, 40, 91 see also Birthing centers; Dialysis treatment centers; Primary/urgent care centers Ambulatory surgery centers characteristics, 35-36 design innovations, 41 equity investment in, 43 for-profit, 36 growth trends in, 36, 226 hospital-affiliated, 36 independent, 36 innovations by, 91 number of, 36 operations performed in, 36 American College of Physicians code of ethics, 161 American Health Capital, Inc., 43 American Healthcare Systems, 10, 29, 43, 503 American Hospital Association data on uncompensated care, 101-102 American Hospital Supply Corporation, 16 American Medical Affiliates, 502 American Medical Association code of edhics, 152, 153-154, 161, 166, 167, 213 policy on physician conflict of interest, 159 political role of, 241 American Medical International growth trends, 109-110, 251-253, 256-257 health maintenance plan, 144 home health care services, 35 number of beds, 252, 474 number of hospitals, 44, 250,474 nursing home ownership, 502 previous ownership of hospitals acquired by, 254, 255 tax obligations and payments, 53 teaching hospital acquisitions, 144 uncompensated care by, 114 American Medical Services, 503 American Medicorp, 251 Americana, 502 Anesthesiologists Board certification of, 131 compensation of, 166, 395, 429, 431, 452, 455 distribution by hospital ownership, 388 Angell Group, 503 ANTA, 502, 503, 509 AFUt Living Centers, 33, 501-503, 520 Associated Health Systems, 41 B Bad debt, see Health care, uncompensated Baxter Travenol Laboratories, 16, 35 Beds banking of, 307 excess of, 49-50, 64, 135, 187 investor-owned, 28, 30, 32, 80, 202, 250, 475 medical residents per, 142. 143 not-for-prof~t number, 29, 30, 32 543

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From page 544...

... 34 Cisil Rights Ounce, data on uninsured patients, 100 101 188 INDEX Clinics, ownership of, 40 Colorado corporate practice of medicine in, 166 financing uncompensated eare in, 119 Community Dialysis Centers, Ine., 38 Community Hospital of Sacramento, 2.53 Community Psychiatric Centers, 32 CompCare behavioral medicine hospital ownership, Comprehensive Care Corporation, 43 Connecticut, nursing home patient discrimination in, 118 Continental Care Centers, .502 Convalescent Serviees, .503 Corporate practice of medicine, 166, 174 Cost-based reimbursement, 50, 51, 56-57, 75, 77, 87, 94-95, 99, 156, 329, 498 Costs, see Finaneial capital, costs; Health care, costs; Hospitals, costs; Multihospital systems, costs; ^Nllrs~ng homes, costs D Debt financing, 54-55, 58-61, 71, 477 Dentists on hospital payrolls, 429, 4.51 Diagnostic centers, 38, 40 Diagnostic Centers, Inc., 38 Dialysis Clinics, Inc., 38 Dialysis treatment centers, 26, 38-40, 93-94 Doetor's Off~eenters, 37 E Eeonomic Beeoverv Tax Aet, 509 Eeonomic theories about health eare organizations, 5, 7, 19-~.5 Education, medical cross-subsidization of, 228-229, 24.5, 248 effects of investor ownership on, 142-150, 190-191, 245-246, 248, 2~6, 397 hospital commitment toward, 26.5, 273-276, 279280, 282, 285-987 public benefits of, 246 Equity financing, 41, 42, .50-51, 61-62, 67-73 Extendieare, 502 Federal Deficit Reduction Aet of 1984, 160 Federal Housing Administration 242 program, 59 Finaneial capital access to, 34, 47-50, 60-69, 65, 67, 184, 196, 283, 508 costs, 47, 56-57, .59-62, 64, 80, 197 earnings, 50, 57, 61 for-prof~t sources, 6, 9, 61, 477 from ~leclicare pay meets, .51, 64, 65, 140 future needs for hospitals, 49 government sources, 50, 57 grants, 50, 54-55.

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From page 545...

... INDEX hospital requirements, 23, 49, 477 interest expenses, 50, 59 investment incentives, 52-53, 62 investor equity, 51, 61-62, 67-73, 191 nature and importance of, 47-73 not-for-profit sources, 6, 9, 61, 62, 64, 477 operating revenues, 50, 262-264, 273-277, 287 philanthropic, 50, 54-55, 57, 59-60, 63, 99, 118119, 184 policy issues regarding, 64-65, 196-197 return-on-equity payments, 50-51, 62, 65 sale of debt instruments, 50, 60, 67; see also Debt ~ . rlnancmg sources for health care organizations, 6, 9, 26, 43, 50-59, 61-65, 184, 201, 218, 218 tax deferral, 53-54, 62, 63 uses, 50-52, 119 working, of HMOs, 48 Finland, hospital ownership and financing in, 57 First Healthcare Corporation, 502 Florida costs of hospital care in, 481-483 hospital acquisitions in, 88, 105, 202, 303-321 hospital emergency rooms in, 109 hospital margins on revenues in, 328 uncompensated care in, 102-103, 105, 119, 188, 202, 319 Forum Group of Indianapolis, 144 Four Seasons Nursing Centers, 500, 502, 503 France, hospital ownership and financing in, 56 Freestanding facilities charges, 106 growth of, 91 hospital competition with, 91, 106-107, 116, 174 multihospital system operation of, 40 ownership, 106, 154-155, 175 quality of care in, 138 services, 106, 154-155 uncompensated care by, 106 see also Alcohol treatment centers; Ambulatory care centers; Ambulatory surgery centers; Birthing centers; Diagnostic centers; Dialysis treatment centers; Primary/urgent care centers G General Care Corporation, 251, 253 General Health Services, Inc., 251, 253 George Washington University Hospital, 144, 145 Geriatrics, 502 Government funding of health care, 11-13, 57 health care organizations, 17, 19, 57 obligations concerning uncompensated care, 113, 110-116, 195, 228, 23o role in health care, 5, 12, 235 stimulation of HMOs, 33 545 subsidization of not-for-prof~t hospitals, 62-63 see also Hospitals, government Group Health Association of Washington, 33 Group Health Cooperative of Puget Sound, 33 GWU Health Plan, 144 H Harvard Community Health Plan balance sheets, 47, 48 flow-of-finds statement, 50-51 Health benefits programs, 27, 41 Health care access to, 97-126, 18(-189, 225-232 amenities, 13, 107, 236 as a commodity, 11-12, 14-15, 183, 220, 233-237, 244 as a social good, 12-15, 182-183, 220 conflicts of interest in, 15, 152, 158-161, 163-164, 197, 214, 217, 219, 237-245, 248, 396 consolidation of providers, 43 costs control of, 91 data sources on, 92-93 definition and measurement of, 74-76 distribution of, 209-210, 213, 210, 220, 228, 230, 231, 247 effect of for-pro~t health services on, 93-94 effect of investor-owned hospital systems on, 480-483 findings about, 185-187 for capital, 47, 51, 56-57, 59-62, 64, 68-69, 71 ,2, 80, 197 hospital post-acquisition increases in, 87, 480 481 measures of, 261-264 monitoring trends in, 92-93 recovery of, 98-99, 113 savings through ambulatory care centers, 186 to community, 80-81, 84, 94 see also Hospitals, costs; Nursing homes, costs data sources on, 92-93, 101-102, 188, 261, 262, 285-286, 403, 422-423 economic incentives in, 192-193 entry barriers, 22, 23, 24 ethical issues, 3-4, 11-16, 17, 111-116, 151-153, 182-183, 192, 209-249, 396 expenditures, 3, 5, 35, 38 financial capital sources for, 6, 9, 26, 43, 50-59, 61-65, 184, 201, 218, 219 government funding for, 6, 9, 11-13, 55 government role in, 5, 12, 235 growth trends, 3, 26-29, 31-38, 47-73, 88, 90-91, 108, 190, 226, 250-259, 290, 292-294 information asymmetry in, 13, 20-21, 23-24, 139 140, 236-237 insurance effects on, 11 key elements of, 13

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From page 546...

... 185-187 quality effects of in`,estor-owned multihospital systems on, 37~-376, 483-487 for-profit status and, 90, 127-141 in freestanding facilities, 138 in hospitals 127-134, 189-190 in not-for-profit organizations, 92 in nursing hones, 131-137, 140, 510-521, 530 531 indicators of, 127-134, 139, 189-190, 376, 487, 515, 519 monitoring, 92-93, 112, 137-139, 156, 190, 199 900 outcome measures of, 133-135, 139, 520 patient judgment of, 13 physician evaluations of, 130-132, 189, 396-397, 399 physician responsibility, 15, 171-174, 237-245 refusal for financial reasons, 98 regulation of, 12, 26-27, 135-136, 242, 246-247, 272-273, 078, 280-981, 284, 286 sectors, 19' 24 services configuration and control changes, 26~6 new, 38-39, 64 outside of hospitals, 27 pricing of, 13, 74-76, 80, 87, 185-186, 277, 287, 994-296 unnecessary, 13, 17, 158-160 vertical integration of, 39-41 see also Hospitals, services structural changes in, 26-46, 92, 260 I.\'DEX tar subsidization of. 903 trends in.

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From page 547...

... INDEX access to capital by, 34, 47-50, 60-62, 65, 67, 184, 196, 283, 508 assets, 47-49, 52-53 behavior of, 5-6, 9-11, 13-14, 20-23, 93, 260-289 combined provider/insurance functions of, 44 competition between for-profit and not-for-profit, 117-118, 183, 232-233, 247-248, 265, 270, 2~2-275, 278, 280-281, 284, 462~64 constraints on, 10-11, 88, 137 credit ratings of, 61 debt financing by, 10, 50, 54-55, 58-65, 67, 71, 184 definitions of, 16 distinctions between for-profit and not-for-prof~t, 5-11, 86, 184-185 diversification by, 39-42, 44 earnings, 50 economic theories about, 5-6, 19-25 efficiency of, 9, 16, 22-24, 75, 186-187, 225, 296, 312, 317-318 expense types, 74 government capital sources for, 57 characteristics, 17 economic rationale for, 19 growth of, 3, 26-38, 47-73, 88, 90-91, 108, 190, 226, 250-259, 290, 292-294 hybridization of for-prof~t and not-for-prof~t, 10, 26, 41-43, 44 incentive bonus arrangements with physicians, 153, 156-107 investor-owned, 3-10 access to care under, 97-126, 225-232 advantages and disadvantages of, 3-4, 97, 187, 226 concerns about, 4, 13, 97-126, 187, 225, 232 efficiency of, 23-24, 75, 18~187, 225 management of, ~7, 16, 23 mission, 6, 60 physician exit and voice mechanisms in, 176-178 profit distribution, 6, 184 profitability incentives, 7, 184-185 rationale for, 21 research activities of, 148 revenue sources, 6, 52 social obligations, 226-230 stool; options, 16-17 subsidization of health care, 227 taxes, 6, 227 types, 183 legal differences in, 184 legal responsibilities of, 98, 112-115, 117, 228 management contract arrangements among, 40-42, 255-256, 271-2-15, 278, 280-281, 284, 286 new types of, 35-39 not-for-profit, 6-10 advantages of, 8, 62-63 547 capital sources, 6, 61, 62, 64 characteristics, 7-8, 232-233 corporate reorganization of, 184 efficiency, 9, 22, 75, 186-181 financing, 8, 10, 17, 62-63 future of, 194 goals and ideals, 8, 75 investment in unneeded equipment and facilities, 9, 22 management of, 6, 22-24 mission, 6, 60 nondistribution requirement, 6, 7-8, 10, 20-21, 75, 184 protection of from competition, 232-233 purposes, 6, 8, 22 quality of, 22 rationale for, 20 revenue sources, 6, 20, 24 tax status, 6, 8, 10, 20, 63, 98, 113-115, 184, 227, 233 tax-exempt bond funding by, 10, 55, 59-60, 62 65,67,81, 184, 197 obligations to provide uncompensated care, 98, 112-115, 117, 228 ownership diversity, 4-5, 16 physician investment in, 153-156, 159, 162-163, 197-198 physician relationship with, 10-11, 15-16, 24 social responsibilities of, 97, 113, 193-194 tax obligations and payments, 53-54, 62, 193-194 Health Care Retirement, 503 Health Central Corporation, 41 Health Insurance Plan of Greater New York, 33 Health Maintenance Organization Act of 1973, 33 Health maintenance organizations, 33-34 balance sheets, 47-49 Blue Cross/Blue Shield, 44 bonus incentive arrangements in, 158, 238 flow-of-funds statement, 50, 51 hospital use rates of, 159 limitation on care by, 238 Medicare market for, 34 multihospital system operation of, 40, 41 multistate, 34, 44 negative aspects of, 219, 238 ownership of, 26, 40 Health Resources Corporation, Inc., 39, 253 Health status indices, 139 Health Ventures, 42 Hill-Burton program, 59, 98, 117 Hillhaven nursing homes operations, 33, 501-503, 509, 520 Home health care, 26-2~, 34-35, 40, 138, 159 Horizon Health. 253 Hospice Care, Inc., 39 Hospice care, 38-39, 121 Hospital Affiliates International, Inc., 87, 251, 253

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From page 548...

... 287, 365-367, 374, 458-473 certificate of need for, 23 charges, 93. 328, 344-349 chief executive officers, 406-408, 414 chief of staff, 409, 416 closures, 105, 109-110,_56-2~7 community interaction of, 458~73 INDEX compensation methods, 393-397 competition between, 117-118, 265, 270, 272-275, 278, 280-281, 284, 462-464 competition with ambulatory care facilities, 91, 106-107, 116, 174, 462, 464 construction trends, 28, 251-253 construction, funding for, 54-55, 57-59, 119 contract management of, 40-42, 255-256, 271-275, 278, 280-281, 284, 286 corporate restructuring of, 41, 307 cost containment committee, 407, 409, 419 costs administrative, 273, 277 allocation methods, 75, 77, 94, 95 data sources on, 323 educational, 119 incurred under diagnostic-related group, 40 input, 265, 272, 279, 282, 285 measures of, 261-264 medical education, 287 of acquisitions, 80, 87-89, 186, 319-320 of care in, 480-483 of equipment, 119 operating, 290 regression analyses of, 322-353 reimbursement for, 56-57 research, 119 cross-subsidization by, 99, 106-107, 312 data sources on, 261, 262 decision making in, 171-172, 175-178, 402-421 director of medical education, 408, 417 discharge information on basis of ownership, 340 343 diversification by, 42, 44, 464 divestitures by investor-owned hospital companies, 256-257 drug utilization review by, 380 dumping of patients by, 104, 119 economic performance factors, 26.5 effect on competitive climate of communities, 462 464 efficiency post-acquisition, 317-318 efficiency pre-acquisition, 312 evaluation of quality, by physicians, 130-132, 189, O99 expansions, 251-253 expenses administrative, 77 after acquisitions, 87, 317-320 analyses of, 92 average annual rate of increase, 77 categories, 296 depreciation and amortization, 52, 59 for drugs and supplies, 80 occupancy effects on, 77 operating, 77, 296-297, 312 patient care, 186

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From page 549...

... INDEX personnel-related, 80 studies of, 76-80 facilities emergency room, 104, 105, 107-109, 117, 122, 298, 46~66 pharmacy, 108, 125, 295, 298 premature nursery, 108, 109, 118, 121, 465 financial arrangements with physicians, 393-396 financial screening of patients, 104 functional strategies governing boards, 405-406, 411 governance, physician participation in, 402-421 government capital sources for, 50 construction Finding sources, 59 contract management of, 41 Medi-Cal patients in, 295, 297-298 uncompensated care by, 98, 114 growth in California, 292-294 influence of physicians in, 157, 171-181, 198-199, 470-471 international ownership and financing, 55-57 investor-owned capital sources, 9, 50, 61 cost of equity financing, 51, 61-62 definition, 31, 224 distribution by state, 31 efficiency of, 225 expenses, 76-80 financial strategies, 287, 290-302 grant eligibility of, 142-143 growth rate, 28 lengths of stay, 77, 93, 9S local property taxes, 53 locational preferences of, 86, 103-104, 183-184, 187, 307 market share, 30 medical residency programs in, 142-144 medical staff composition, 389, 400 Medicare capital payments to, 51, 65 number of, 28, 44, 183 patient outcomes in, 140, 367 physician attitudes toward, 394, 396-398 physician involvement with, 386-392 pricing strategies, 287 profitability, 287 quality of care in, 367 research in, 142 response to financial incentives, 29~301 return-on-equity payments, 50-51 revenue sources, 9 size of, 29, 255 tax deferral by, 54, 62 taxes, 119 uncompensated care by, 213, 483 see also Ownership/affiliation comparisons, hospitals 549 joint ventures of, 41, 43, 1~5 leasing arrangements with physicians, 175, 393 legal responsibilities, 98, 105, 117 lengths of stay in, 157, 159, 992, 338-339, 359-363 long-range planning committee, 407, 409, 420 management of by physicians, 406-408 markups, 84, 262, 277-280, 287 Medicaid caseload in, 305, 306, 312, 313, 317 medical education commitment of, 265, 273-276, 279-280, 282, 285-287 medical resident/bed ratio, 142, 143 medical staff applications, 423-42S, 430 committees, 407-409, 418, 420 qualifications, 128-130, 131 salaries and benefits, 80, 312 size and composition, 174, 313, 422-426, 430, 434, 440-445 Medicare capital payments to, 51 Medicare case mix in, 359 membership in alliances, 41 methods for assuring payment, 467 modeling of behavior of on basis of affiliation and ownership, 260-289 monitoring care in, 137-138 monitoring physician patterns of care by, 156 mortality rates by type of, 357-365, 367-368, 371, 273 net margins, 9, 201-202 not-for-prof~t beds, 29, 30, 32 capital, 9, 80 characteristics, 232-733 expenses, 66, 76-77 financial incentives, 290-302 management by investor-owned systems, 41 price differentials between for-profit systems and, 80, 464 protection from for-profit competition, 232-233 response to financial incentives among, 290-303 revenue sources, 9, 42, 66, 93, 233 tax exemptions, 114, 116, 157 uncompensated care by, 98, 114, 116, 225, 228, 232-233, 465-467 nursing support adequacy, 132, 189, 397 obligations to provide uncompensated care, 112 115 occupancy rates, 39-40, 49, 64, 77, 87, 94, 95, 186, 283, 286, 292, 301, 306-307, 312, 326 organizational mission, 354-374 outcomes relative to size of, 359 ownership, 4, 28, 40; see also Ownership/aff~liation comparisons, hospitals patient selection strategies, 262-263, 265, 272-275, 281, 284, 287, 312 payer mix in, 391 pricing

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From page 550...

... actuarial risk assumption by, 41 acute care hospital ownership, 44 balance sheet, 47, 49 capitalized lease arrangements, 258 dividends, 61, 70 flow-of-funds statement, 50, 52 growth trends, 109-110, 250-253, 256-257 interest rates on long-term debt, 61 market effects on facility ownership, 288 mergers, 251 number of hospitals, 250, 474 primary care center ownership, 37-38, 40-41 relationship with Symbion, 149 research grants by, 148 revenue sources and uses, 50, 52 size, 3, 474 stock options, 17, 61 tax obligations and payments, 53 teaching hospital affiliations, 144 uncompensated care by, 114 HumanaCare Plus program, 41 Hyatt, 251 Independent practice associations, 238 Insurance effects on health care market forces, 11

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From page 551...

... , 144 Minnesota nursing homes admission discrimination in, 118 quality in, 514 Mission Services Corporation, 43 Models competitive market, 19 economic, 19-24 Monterey Life Systems, 502 Multihospital systems access to capital, 61, 477~78 accreditation trends of, 364-367, 375-384 acquisitions of by other chains, 251 administration of hospitals in, 467-470 advantages and disadvantages of affiliation with, 27, 60-61, 375-376, 469-470, 477~80, 486 bond ratings, 60-61, 478 borrowing power, 26, 60, 477 case mix, 368 characteristics of hospitals in, 461470 comparison of investor-owned and not-for-profit, 29-32 compensation arrangements with physicians, 422457 diversification by, 478479 economic benefits of membership in, 477~79 economic perfonnance of hospitals in, 260-289 economies of scale, 287-788 effects of membership in, 467468 investor-owned access to care in, 105-106, 483-486 accreditation status, 367-368 acquisitions, 105-106, 117, 250-256 advantages and disadvantages, 105, 189, 329, 476477 balance sheet, 47, 49

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From page 552...

... 479433 tax obligations and payments, 53-54, 62, 195 teaching hospitals, 143-149 uncompensated care bv 103 486 ,, , vertical integration of services by, 40 local control in, 61, 467-470 medical staff sizes, 422-457 modeling of behavior of, 260-289 not-for-prof~t beds. 29, 30, 32 capital raising by, 61 corporate restructuring of, 42 diversification by, 40 fornication of, 98-29 geographic distribution of hospitals, 287 government subsidy of, 69-63 investor-owned subsidiaries of, 42 management of for-prof~t hospitals by, 41 management of, 468469 number of hospitals in, 29, 30 religious/secular breakdown, 29 vertical integration of services by, 40 occupancy rates, 39-40, 77, 95 personnel management by, 479 physician privileges, 422-457 planning by, 479 political power of, 479 pricing strategies, 277 quality of care in, 375-377, 483-487 revenue sources, 41 size, 29 types of health services, 26 vertical integration of services by, 39 see also Hospitals; Ownership/aff~liation comparisons N National Association of Private Psychiatric Hospitals, 44 National Health Care Affiliates, 503 National Health Corporation, 503 National Health Enterprises, 502, 507 National Health Planning and Resources Development Act of 1974, 118 National Health Services, 502 National Medical Care, 38 National Medical Enterprises diversification by, 476 educational endowments by, 148 growth trends, 109-110, 250, 252-257 home care enterprises, 35 number of hospitals, 44, 2.50, 474 nursing home operations, 33, 528 psychiatric hospital ownership, 32, 44 revenue sources, 40 tax obligations and payments, 53, 114, 119 teaching hospital construction, 144 uncompensated care by, 114 vertical integration of services by, 40 National Medical Home Care, Inc.

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From page 553...

... S health care organizations, 4-5, 16 freestanding facilities, 106, 154-150, 175 geographic patterns, 183-184 government role in, 5 health care costs on basis of, 74-96, 185-187, 322 353, 480-483 hospitals accreditation trends on basis of, 128-129, 189, 364,367, 374, 378-379, 382-383 activity and productivity on basis of, 283-287 acute care, 28 admissions by sources of payment and, 101 bed capacity on basis of, 30, 32, 80, 250-251, 270, 272-275, 279-280, 282-283, 285 Board chairman responsibilities on basis of, 132 133 Caesarean section rates by, 134-135, 138 capital structure on basis of, 263-264, 280-283, 287 case-mix differences on basis of, 271-278, 281, 283,284, 287, 366-367, 374 case studies of, 458-473 changes in, 305 charge structure according to, 296, 298, 328 closures on basis of, 109-110 comparison of nursing home ownership and, 134, 187 competition on basis of, 265, 270, 272-275, 278, 280-281, 284 conflicts of interests in, 159-160 contract management on basis of, 271-275, 2~8, 280-281, 284, 286 cost comparisons relative to, 322-353 cost-effectiveness on basis of, 290 deductions from revenue on basis of, 297 discharge information on basis of, 340-343 distinctions between, 5-11, 86

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From page 554...

... 77, 95 medical education implications of, 142-150, 190 191, 245-246, 248, 276 medical residency programs and, 142, 143 multihospital system advantages and disadvantages, 469-470 nursing homes comparison of hospital ownership with, 134 costs by, 89-90, 186, 521 patient discrimination on basis of, 528-529 quality of care on basis of, 136-137, 510-521 physician perspective on, 385~01 physician voice in hospital on basis of, 176-178 primary/urgent care centers, 36-37, 175 relationship to sources of capital, 57-59 research implications of, 142-150, 190-191 types of, 4, 16 uncompensated care on basis of, 97-116, 187-188 213, 225-226, 228, 232-233, 465-467 p Parkside Medical Services Corporation, 42 Pathologists Board certification of, 131 compensation of, 166, 395, 430, 432, 454, 457 distribution by hospital ownership, 388 Patients dumping of, 104 heavy care, 110-111, 118 Medicare in nursing homes, 110, 136 outcomes, 354-376 physician attitudes toward, 14 readmission rates, 134 outcomes 133-134, 135, 354-376

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From page 555...

... 470-471 in hospital decision making, 24, 174-179, 198, 402, 421 in nursing homes, 135, 137 internal medicine, 388, 395, 426, 434, 443 investments in health care organizations, 153-156, 159, 162-163, 197-198 involvement in for-profit hospitals, 385-401 joint ventures with hospitals, 155-156 laboratory ownership by, 156, 166 laboratory test ordering by, 158-160, 167 leasing arrangements with hospitals, 175 license suspension, 161 locational preferences of, 141-142 medical specialty, 129, 131, 426, 444 and Medicare, 14, 241 moral obligations of, 240-241 OB/GYN, 131, 388, 395 perspective on hospital ownership, 385~01 policy options regarding, 159-165 practice patterns, 385401 preferences in hospitals, 397 public trust in, 151 qualifications of for hospital staff privileges, 128 130, 131 referral and admission patterns, 173-175, 178, 179 refusal to accept patients, 212-213 relationships with health care organizations, 10-11, 15-16, 24 relicensing of, 214 responsibilities to patients, 15-16, 24 responsibility for quality, 171-174, 237-245 self-regulation, 242, 24~247 services, volume of, 14, 156, 158-159, 238 surgical specialty, 129, 131, 388, 434, 445 surplus of, 37 third-party payments to, 14 unionization of, 180 Preferred provider arrangements, 41 Presbyterian-St. Luke's Hospital (Denver)

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From page 556...

... 371-373 sales on 17 Surgicare, Inc., 36 INDEX Sweden, hospital ownership and financing in, 56 Svmbion, 149 T Tax Equity and Fiscal Responsibility Act, 366, 506 Taxes ACES, 54 deferred, 53-54 exemptions from, 6, 8, 66, 113-114, 227 health care subsidization with, 203 investment credits, 509 of investor-owned health care corporations, 53-54 policies relevant to nursing homes, 509-510 Tennessee, uncompensated care in, 102-103 Texas corporate practice of medicine in, 166 Medicaid utilization rate in, 528-529 nursing homes, 508, 517-520, 524-525 uncompensated care in, 102-103, 117 Tulane Hospital (New Orleans) , 144 U Uncompensated care, see Health care, uncompensated Unicare, 502, 503, 509 Unifour Medical Management, 503 United Healthcare Corporation, 34 United Kingdom, hospital ownership and financing in, 56 University of Mississippi Hospital, 144 Upjohn Health Care Services, 35 U.S.

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Index Pages 543-556

Index
Pages 543-556