January 2009 Issue of Hospital Review

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Top 10 Hospital Stories of 2008; 15 Hospitals with Great Orthopedic and Spine Programs; 5 Key Concepts from the William Blair & Company Survey of Hospital Administrators; Hospital Real Estate and Financing Q&A With Mike O'Keefe of Navigant Consulting; Top 10 States With More Hospitals Than Surgery Centers; Quint Studer Discusses 5 Important Issues Facing Hospital Leaders; 5 Factors Influencing a Hospital’s Value; 4 Critical Concepts From the Latest Stark Act Regulation; National and Regional Benchmarks for Hospital Profit Margin and Cash-to-Debt Ratio; 22 Investor-Owned Hospital Companies to Know; Will the Federal Government Shut Down Surgery Centers and Physician-Owned Hospitals?; Top 10 States With More Surgery Centers Than Hospitals; 15 Healthcare Trends and Observations; Kenneth Hawkins Discusses 3 Key Capital Partner Issues for Community Hospitals; Serious Recession Could Greatly Harm Hospitals — And Not Just Because of the Uninsured; 6 Insights on Physician/Hospital Surgery Center Joint Ventures From Dick Hanley of Health Inventures; Distribution of Hospitals and Surgery Centers by Population Levels; Revenue Per Case by Specialty in Surgery Centers
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Top 10 Hospital Stories of 2008
Healthcare observers were split between the November elections and the economic downturn as their choices for the top hospital stories of the years. Both impacted hospitals in multiple ways and will continue to exert influence on hospital finances and operations and access to quality hospital care for years to come.
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15 Hospitals with Great Orthopedic and Spine Programs
Cleveland Clinic. This academic medical center is located in Ohio and treats a variety of musculoskeletal impairments in its orthopedic department and has its very own center for spine health. Established in 2003, it covers the full scope of spinal services. The center has specialists in neurosurgery, orthopedic surgery and medical spine, as well as experts in manipulation and interventional pain management. These specialists work together to diagnose and treat spinal disorders, including scoliosis, spinal stenosis, chiari malformation and spinal tumors. For the past several years, U.S. News & World Report has consistently ranked the Cleveland Clinic’s department of orthopedic surgery among the nation’s top five orthopedic programs and the number one program in Ohio. Each fall, physicians in the orthopedic department publish an orthopedic insights newsletter, which can be obtained online.
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5 Key Concepts from the William Blair & Company Survey of Hospital Administrators
This article briefly highlights five concepts from the William Blair & Company survey of hospital administrators. The survey included discussions with 27 administrators and 10 senior executives and specifically focused on capital spending and the impact on companies such as Intuitive Surgical (the DaVinci Robotic), Stryker Corp. and TomoTherapy (linear accelerators). The report was issued on Dec. 3. The report was extremely informative and intelligently done.
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Hospital Real Estate and Financing Q&A With Mike O'Keefe of Navigant Consulting
Mike O’Keefe, a director in the healthcare real estate group of Navigant Consulting, a practice which provides facility development, program management, real estate advisory, strategic planning, performance improvement, facilities planning and capital advisory services to healthcare providers throughout the United States, answers five critical questions concerning hospital real estate and financing.
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Top 10 States With More Hospitals Than Surgery Centers
Here are the top 10 states with more hospitals than surgery centers, ranked by ratio of hospitals per surgery center, according to SDI’s 2008 Outpatient Surgery Center Market Report. Ratio of number of hospitals per surgery center (ASC) is indicated in parentheses.
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Quint Studer Discusses 5 Important Issues Facing Hospital Leaders
Quint Studer, founder of the Studer Group, a healthcare consulting firm that coaches thousands of leaders at organizations worldwide on creating and sustaining service and operational excellence, and recently named one of the “Top 100 Most Powerful People” by Modern Healthcare, discusses five of the most important issues he believes currently face hospital leadership.
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5 Factors Influencing a Hospital’s Value
While most business sectors have seen a slowdown in merger and acquisition activity during the current financial and credit crisis, the hospital sector continues to see a significant level of activity. The driving forces for this activity have changed and valuations are varying more dramatically than the sector has seen historically. For hospitals considering selling part of their organization or those facilities interested in mergers or acquisitions, it is critical to know how hospitals are valued and the driving forces behind these trends.
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4 Critical Concepts From the Latest Stark Act Regulations
The Centers for Medicare and Medicaid Services (CMS) has, over the last several years, grown increasingly concerned with percentagebased lease arrangements, indirect financial relationships, per click payments and “under-arrangements” transactions. It has long indicated that changes to the Federal Ethics in Patient Referral Act (the “Stark Act”) were required in order to address their concerns. The latest Stark Act rules were released on August 19, 2008, in the Federal Register as part of federal regulations covering a variety of subjects relevant to healthcare providers. The changes to the Stark Act regulations address several concepts that will directly affect physicians, hospitals and the entrepreneurial relationships between and of each. This article briefly discusses four of the more important changes.
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National and Regional Benchmarks for Hospital Profit Margin and Cash-to-Debt Ratio
Here are national and regional benchmarks for operating profit margins and cash-to-total-debt ratios for hospitals honored as the nation’s top 100 hospitals by Thomson’s National Benchmarks for Success program.
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22 Investor-Owned Hospital Companies to Know
Ardent Health Services. Based in Nashville, Tenn., Ardent owns and operates 11 acute care hospitals, two multi-specialty physician groups, a 220,000- member health plan and one national medical laboratory. A partner of some the most respected names in healthcare, such as Ochsner in New Orleans and Lovelace in Albuquerque, Ardent reports $1.7 billion in revenues for 2006. The company’s medical/surgical hospitals and health systems employ 10,000 people in growing urban and suburban areas. Ardent says it focuses on consistent reinvestment, with a systemwide focus on quality and access to shared administrative and clinical resources.
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Will the Federal Government Shut Down Surgery Centers and Physician-Owned Hospitals?
As the Democrats take control of the House, the Senate and the Presidency, many question the impact of such a change on ambulatory surgery centers (ASC) and physicianowned hospitals. The most significant question is: Will the federal government shut down and/or restrict physician-owned hospitals and ASCs?
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Top 10 States With More Surgery Centers Than Hospitals
Here are the top 10 states with more surgery centers than hospitals, ranked by ratio of surgery centers per hospital, according to SDI’s 2008 Outpatient Surgery Center Market Report. Ratio of number of surgery centers per hospital is indicated in parentheses.
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15 Healthcare Trends and Observations
This remains a challenging time in the healthcare industry. Unfortunately, it is also an interesting and fascinating time in the general economy as a whole. This article outlines 15 short observations regarding trends and concepts in the healthcare industry.
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Kenneth Hawkins Discusses 3 Key Capital Partner Issues for Community Hospitals
As community hospitals face increases in competition, declines in admission rates and decreases in profits, along with the current national credit crunch, some organizations are considering whether to sell a portion of the hospital to a capital partner. While such an approach may be a wise decision to ensure stability, it is a decision that should not be made impulsively, says Kenneth Hawkins, vice president of acquisitions and development at Community Health Systems (CHS).
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Serious Recession Could Greatly Harm Hospitals — And Not Just Because of the Uninsured
Agreat deal of publicity has accompanied the recent so-called “financial crisis” in the United States in regards to the hospital bond markets, a dislocation that appears to be producing a pronounced capital access backlog in the hospital sector and flat-out lack of capital access in other provider sectors. In addition, recent publicity has also mentioned, within a limited context, the impact that much larger numbers of uninsured could have on hospital operations including a recent Moody’s announcement warning that this could affect performance in the for-profit hospital sector. However, there is very little written about the true scope and breadth of the adverse effects of a serious and prolonged recession on hospitals and nearly every other type of health care provider.
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6 Insights on Physician/Hospital Surgery Center Joint Ventures From Dick Hanley of Health Inventures
Dick Hanley, president and CEO of Broomfield, Colo.-based Health Inventures, which specializes in developing and managing ambulatory surgery centers (ASC) and imaging centers, often brokering partnerships between hospitals and physicians, offers the following six predictions and assessments relating to physician/hospital ASC joint venture trends in 2009.
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Distribution of Hospitals and Surgery Centers by Population Levels
Here is the distribution of hospitals and surgery centers and by population levels, with percent of total number of each facility type in parentheses, according to SDI’s 2008 Outpatient Surgery Center Market Report.
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Revenue Per Case by Specialty in Surgery Centers
Here are how specialties fare in terms of gross charges and net revenue per case in ambulatory surgery centers; they are listed in descending order of net revenue achieved. These figures come from the VMG Health 2008 Intellimarker.
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