MedUnite Uses Web for Claims Handling, Beckman Uses It to Sell to Premier
Not-for-profit hospitals and their representatives in Orange County and other parts of the U.S. have steadily complained about how Balanced Budget Act of 1997 reimbursement freezes and other financial factors have affected their sector. But Standard & Poor’s, the financial rating agency, recently came out with a positive outlook for not-for-profit hospitals.
In published reports, S & P; asserted that the sector should have better operating results this year and in 2001. The rating agency said it based its outlook on a combination of hospitals eliminating or revamping unprofitable health maintenance organization contracts and physician operations, along with proposed reimbursement relief in Congress and negotiated rate increases from insurance companies.
Some hospital experts, however, see things differently than S & P.;
“On the local level, I do not see a rosy future for not-for-profit hospitals in the state of California and specifically Orange County,” said Kimberly Cripe, Children’s Hospital of Orange County’s president and chief executive. Cripe said that CHOC, which has suffered some large operating losses in recent years, is projecting a small gain for its upcoming fiscal year.
CHOC posted a net loss from operations of $1.2 million in 1999, compared with a net loss of $8.6 million in 1998, according to the Business Journal’s most recent hospital list.
Cripe said CHOC is being affected by several factors, including an ongoing shortage of nurses and other workers. She noted that the Orange facility has invested $3 million back into workforce development. “That’s a huge issue for an organization like ours,” Cripe said.
Another issue, Cripe said, was a decline in federal payments made to hospitals that care for large numbers of uninsured or underinsured patients.
Cripe also cited the costs of retrofitting facilities to bring them up to California’s new seismic safety code, new medical technologies and pharmaceutical prices “that are through the ceiling.”
“I have no idea how they reach those assumptions,” said Jan Emerson, a spokeswoman for the California Healthcare Association. S & P;’s conclusions “are certainly not true in California,” Emerson said, citing an association study that showed 64% of all California hospitals had negative operating margins in 1999. That study did not break out numbers for not-for-profit facilities.
“I don’t see that trend changing,” Emerson said, noting that congressional efforts to restore some funding lost after the Balanced Budget Act have stalled.
MedUnite Debuts Web System
MedUnite Inc. formally unveiled its plans for a Web-based transaction system for physicians, hospitals, insurance companies, pharmacies and laboratories. San Diego-based MedUnite’s founding investors include Santa Ana-based PacifiCare Health Systems Inc. and two other Southern California-based health plans, Health Net Inc. and Well Point Health Networks Inc.
MedUnite said its system would enable users to send and receive eligibility and benefits verification, claim submissions, claim status reports, referrals and authorizations. The system’s technology providers include Computer Sciences Corp., Deloitte Consulting, Sun Microsystems Inc. and Xcare.net Inc.
MedUnite also said that it named Dave Cox, a former official and director of Science Applications International Corp., president and chief executive. Cox, in a news release, asserted that MedUnite would make handling healthcare business transactions “as easy as using an automated teller machine.”
Beckman, Premier Take to Web
Fullerton-based Beckman Coulter Inc. and two San Diego-based companies, the Premier Inc. health alliance and medibuy.com Inc., announced they are developing Internet-based purchasing and information systems. The companies said that Premier alliance members would be able to purchase Beckman’s diagnostic instrument systems and supplies over the Internet through medibuy.
Medibuy, an e-commerce company specializing in healthcare supply-chain efficiency, has a partnership with Premier for technology and applications that support the latter’s group purchasing program for approximately 1,850 hospital and healthcare system members.
Clarification:
The Healthcare Association of Southern California says material from a study on local healthcare needs cited in the Oct. 30 health column came from a 1999 Orange County Healthcare Needs Assessment report and that a United Way study served as a receptacle for the data.
Bits and Pieces:
The California Department of Mental Health awarded the Orange County Health Care Agency, Santa Ana, a $1.2 million grant to provide integrated services to mentally disabled homeless adults. The agency plans to implement programs in January, after the funding becomes available … Cardiac Science Inc., Irvine, recently sponsored a symposium for cardiologists at the American Heart Association’s annual Scientific Sessions. Cardiac Science makes a bedside heart monitor-defibrillator; the session examined ways to improve survival rates for patients who suffer cardiac arrest in the hospital … Bristol Park Medical Group, Orange, and Monarch HealthCare/Physician Weblink, Mission Viejo, were elected to the California Association of Physician Associations’ governing board of directors. The association is made up of medical groups and independent practice associations around the state.
