Federal Scene

• Applied Management Systems survey hospital and healthcare presidents and senior executives. Here’s the 2007 Top Healthcare Trends...Are you focused on these?

1. Strong focus on quality
2. Consumer demand for transparency
3. Patient safety
4. Healthcare access for universal and underinsured
5. Moving health into “other” delivery models—CVS, Walgreen’s, community health centers
6. Re-employment of physicians by hospitals/systems
7. Workforce shortages, doctor shortages and funding for nurse education
8. Health-deductible health insurance and HSAs
9. The internet as a healthcare information resource
10. Western medicine costs continue to rise

• San Diego, CA, awesome July weather—Here - Hot! Contact the AHA to register.
• Study: Negative Margins Threaten Solvency A large and growing number of hospitals are at risk for insolvency if their sources of non-patient funding falter, according to a new study by the Alvarez & Marsal Healthcare Industry Group.
  
  At least 2,044 U.S. short-term acute-care hospitals had a patient-care margin that averaged less than 0% for 2005 and 2006, the study found.
  
  These hospitals “must relay on non-patient care sources of funding to remain viable”, the author said. “This is a financially risky business model since non-operating sources of hospital funding are more sensitive to general economic cycles.” The study estimates there are “scores of hospitals that are slowly asphyxiating and slipping into insolvency as they divert capital dollars to fund operations.”
  
  Even among hospitals considered “profitable”, the study said many do not generate sufficient cash flow to fund essential capital expenses that are necessary to comply with government regulation.
  
  For more information on the study. “Hospital Insolvency: The Looming Crisis”, go to www.alvarezandmarsal.com
• According to the American Hospital Association (AHA), “the enrollment in baccalaureate nursing programs grew 5% in 2007, but 30,709 qualified applicants were turned away due to a shortage of faculty and other resources.”
• Bill Would Ease Nurse Visa Backlog, Bolster Nurse Education AHA-backed legislation recently introduced by Rep. Robert Wexler, D-FL, would set aside 20,000 employment-based visas in each of the next three years for foreign-educated registered nurses and physical therapists. The bill, H.R. 5924, also would provide funds to help U.S. nursing schools expand the domestic supply of nurses, and establish a three-year pilot program aimed at keeping U.S. nurses in the workforce. The U.S. has a waiting list for employment-based visas for internationally-educated nurses, and its nurse education programs turned away more than 150,000 qualified applicants last year due to lack of faculty and clinical space.
• Not Time to Cut Medicaid The nation’s economic downturn is pushing many states into serious budget shortfalls, with dire implications for Medicaid.
  
  Twenty-three states and Puerto Rico are forecasting some $26 billion in budget deficits for the coming year, according to the National Conference of State Legislatures. Many states will have little choice but to cut back their Medicaid program to meet legal requirements that they balance their budgets.
  
  Conversely, in these hard times, the number of Americans needing Medicaid services is expected to grow significantly. The Kaiser Commission on Medicaid and the Uninsured estimates that each percentage point rise in the unemployment rate would increase Medicaid enrollment by 1 million people as more families fall into poverty.
  
  It’s hard to imagine a worse time to cut billions of dollars in federal Medicaid spending, but that’s exactly what the Center for Medicare & Medicaid Services (CMS) wants to do. The current moratorium on CMS rules affecting public safety net and teaching hospitals ends on May 25. The House recently passed a one-year moratorium on those rules and other Medicaid regulations that would hurt poor Americans and those who provide their health care. But opponents are working to derail the bill’s chances of passing the Senate.
  
  Don’t let that happen. Contact your legislators today and urge them to help ensure continued access to care for those most in need. Block the Medicaid rules!