RevCare Completes Acquisitions; UCI Prof Heads Up Study
Medicare HMO executives have been calling for Congress to dole out more funds for their plans ever since the Balanced Budget Act of 1997 was passed, capping reimbursement increases at around 2% a year.
The requests continued last week at a town hall meeting sponsored by Secure Horizons, the Medicare plan of PacifiCare Health Systems Inc., Santa Ana.
“You guys have power. Contact your congressional leaders,” said Brad Bowlus, president and chief executive of PacifiCare’s health plan division. Congress “cut back way too much,” he asserted to the audience of about 200 people at Concordia University in Irvine. “We’ll do our best to hang in there. We are absolutely committed, but you need to help.”
Secure Horizons is among the largest Medicare HMOs in the United States, and approximately 600,000 of its 1 million members are in California.
Bowlus, during his presentation, used a chart showing that the so-called “fairness gap” between Medicare costs and what the government pays to HMOs would reach nearly $200 per patient by 2003. He also produced a pie chart derived from internal sources that showed Secure Horizons spends 77 cents of every $1 it receives on contracting for hospital and physician services, while 10 cents goes to administration.
The California Medical Association’s 1998-99 Knox-Keene Health Plans Summary showed that PacifiCare of California spent 83.9% of its revenue on medical care and 9.3% on administrative costs, with 6.8% counted as “profit and income.” That report doesn’t separate commercial and Medicare HMOs.
Information packets passed out to attendees also had a postcard from a group called the Coalition for Medicare Choices, which is linked with the American Association of Health Plans, a trade group that’s led fairness-gap narrowing efforts. The coalition’s activities include a letter-writing campaign to Congress.
Fairness gaps weren’t the only items on the agenda. Among other things, Carolyn Iteen, a clinical pharmacist who works for Secure Horizons, talked about how members could help control prescription costs through communicating with physicians.
Iteen drew laughter from the crowd when she read a question from an unidentified audience member during the town hall’s question-and-answer period. “Is there a generic to replace Viagra? Not yet,” she said. Viagra, Pfizer Inc.’s drug to treat male sexual dysfunction, is popular among older men.
PacifiCare began having its town hall meetings in 1998, during a time when industry critics were demanding more regulation of managed care. Some observers noted that PacifiCare might be using the meetings both as a means to position itself in the Medicare market and to blunt demands for patients’ bills of rights.
RevCare Buys Four Firms
RevCare Inc., Cypress, completed the acquisition of four companies that manage healthcare revenue cycles. RevCare acquired all of the outstanding stock of Orange County Professional Services Inc., which itself acquired the assets and liabilities of Insource Medical Solutions LLC, RBA Rem-Care Inc. and Hospital Employees Labor Pool.
The combined firms manage approximately $788 million in receivables and have annual placements of approximately $429 million. They also have 300 employees in four facilities in Southern California, Las Vegas and Hawaii.
RevCare said the acquisitions will allow it to offer various revenue-cycle services, including billing, collections, reimbursement maximization and staffing. RevCare also hired Gary Burdick as executive vice president and chief operating officer. Burdick most recently was regional vice president of Medaphis Corp.
UCI Prof Chairs C-Section Panel
Roger Freeman of the University of California, Irvine College of Medicine, chaired a panel of the American College of Obstetricians and Gynecologists that outlined practices and conditions linked to higher rates of Caesarian sections. Freeman, a volunteer faculty member, is a clinical professor of maternal and fetal medicine.
Published reports said the professional organization is issuing new guidelines to reduce unnecessary C-sections and reserve the surgery for mothers and babies who really need it. The federal government issued figures this month that showed C-sections climbed from 18% of live births in 1998 to 22% in 1999.
Bits and Pieces:
PacifiCare said it was repurchasing 750,000 shares of its stock from UniHealth Foundation, its largest stockholder, at $59.82 per share. Separately, David Carpenter, UniHealth’s chairman and chief executive, said he was resigning from PacifiCare Health System’s board of directors in order to devote more time to the foundation … Dr. Eric Eeckhout, a European clinical investigator, performed a case demonstration using a catheter produced by Radiance Medical Systems Inc., Irvine. Eeckhout performed the procedure during the European Society of Cardiology’s 22nd congress in Amsterdam … A one-day course on “Current Issues in Dentistry for Children” is scheduled for Sept. 9 at Millers Children’s Hospital at Long Beach Memorial Medical Center. Sponsors are PacifiCare Dental/PacifiCare Dental & Vision Administrators and Children’s Dental Health Clinic in Long Beach. Advance registration is $185 for dentists and $95 for dental staff, while on-site registration is $200 for dentists and $100 for staff. To register, call (562) 933-2501.
