Monday, May 07, 2007

Another Kick in the Pocket...5/11


CMS* is also transitioning from basing DRG weights on hospital charges to estimated hospital costs. Studies by the Medicare Payment Advisory Commission have indicated that hospitals charge significantly more than their costs for some types of services, such as medical supplies and radiology. As a result, certain services are relatively more profitable, potentially contributing to the development of specialty hospitals which focus on high margin conditions. By basing DRG weights on estimated costs, rather than hospital charges, hospital payments will be more closely aligned with the actual costs of patient care, and the incentive for hospitals to take higher margin cases will be reduced. In October 2006, CMS began to phase in the new cost-based weights. The phase-in will take three years.



*Centers for Medicare & Medicaid Services



Remember the link to the comparison of procedure and treatments for Texas hospitals? Well, Paris came out higher than many, in some cases higher than most. This might just pull that rug out from under Hud.


It might give Open Imaging more of a run for their money, since they charge significantly less for procedures than the hospital...however, they(OI) still have newer equipment, and reports are usually available that day, rather than that month....


It might even slow some of the Dallas flight, but where would you rather have treatment: Baylor, or here? They are lower in cost than PRMC in a lot of things, and if all costs were equal....


There are some that think that the blog is aimed at the employees of the hospital. No, it is aimed to those employees that are trapped by circumstances in a poor situation. We don't blame you for having to stay here (...boy, can we relate...) but, we either want to generate a change in attitude, or a change in ownership.


Dick's last hospital, you know, the one that went bankrupt, was bought by a physician consortium...and no more Dicky. We got him. Maybe we could follow their lead? ...hint, hint....

Why Monopoly images? Just remember the quote from Essent: "We hope to make this 'the' hospital in the region...."

18 comments:

Anonymous said...

I am just an ordinary citizen. Used to be on the hospital advisory board - both hospitals at different times. In the past few years, I have seen enough and heard enough and experienced enough that I will take my family anywhere but PRMC. No offense to those good employees who work there, and there are some, but I want appropriate treatment when I or a family member or friend has to go to the hospital. Not a crap shoot. Even in an emergency - no, especially in an emergency, I am going elsewhere. It will take new ownership and a couple of years of outstanding performance before I can overcome my reluctance to use this so-called hospital. Our leading citizens have led us down the garden path - and not just in the matter of our hospital.

Nick said...

10:27....
Well said.

Anonymous said...

10:27,

I agree with all you said except the last part about the leading citizens leading us down a garden path- it was more like a trash chute. They applaud themselves and clap each other on their shoulders, accompanied by the choir of Graxiola and company at the Snooze, all the while ignoring the present situation. I was an employee in Paris back when there were two hospitals, and also during the Christus slide and Essent debacle. Makes me sick to see how the "leading citizens" of Paris screwed this one up, all because they listened to and believed in lies rather than do a little research.

If and when new ownership assumes control, the so-called "leaders" need to listen to their counterparts in Muskogee, OK and Weatherford, TX, and actually act upon their advice.

Paris's "leaders" looked a gift horse in the mouth, never realizing it was a sway-backed, broken down old plug.

Anonymous said...

10:13
At least those communities did listen to that little voice in their heads:


RUN, FOREST, RUN!!!!!!!!!!!

Anonymous said...

I WAS INVOLVED AT THE TIME OF THE MERGER ; THE MEMBERS OF THE BOARD WERE ESSENTIALLY FIGUREHEADS BY THE TIME CHRISTUS DECIDED TO BUY MC CUIOSTION (PRESBY, TEXAS HEALTH RESOURCES)THAT WAS BROUGHT HOME FORCEFULLY A YEAR EARLIER, WHEN SEVERAL MEMBERS OF THE BOARD OBJECTED TO THE DISSOLUTION OF THE PRIMARY CARE 501 CORPERATION AND WERE FURTHER OVERRULLED WHEN THE DECISION WAS MADE TO FILE BANKRUPCY THIS RESULTED IN MANY OF THE MDS LOSING RETIREMENT CONTIBUTION AS WELL AS NEVER BEING COMPENSATED FOR THE SALE OF THEIR PRACTICES.THIS SAME MAFIA BOSS THAT RAN THE CHRISTUS SYSTEM WAS THE SAME GOON THAT SOLD THE HOSPITAL TO THE PRESENT GOONS;THE BOARD HAD ABSOLUTLY NO POWER TO BLOCK EITHER OF THESE ACTIONS.TO BLAME CIVIC LEADERS FOR THE PRESENT MESS IS TO FORGET THAT THE BOARD BY THAT TIME WAS ONLY A N ADVISORY BOARD, AND WAS , IN FACT TOLD THAT WHEN THEY WERE OVERRULED BY THE MOTHER SUPERIOR OF THE ORDER, MONTY MC CLARREN , AND THE MAFIA BOSS ; IN HIS WORDS"THESE THREE VOTES OUT VOTE YOUR TEN!
SO SAVE YOUR SCORN FOR THE ORIGINAL DECISION TO GIVE UP LOCAL CONTROL OF OUR HOSPITAL; ONCE THE DECISIONS STARTED COMING FROM DALLAS AND SAN ANTONIO, WE DIDNT COUNT FOR SQUAT, DO YOU THINK THE CURREN BOARD COULD DECIDE ANYTHHING OPPOSED TO ESSENT
?IF YOU DO ASK ONE OF THEM,THEIR NAMES ARE ON THE ESSENT WEBSITE.

Anonymous said...

9:10,
Two things:

First, try typing in lowercase- typing in all caps looks like you're shouting.

Second, why is it that certain former board members took credit for the sale to Essent (read the piece in the Snooze about Sparkman)? Delusion, or just another Snooze fluff piece?

You sound like you were one of those swayed by the flash & sizzle Essent tossed out.

Anonymous said...

Frankly, when the current board accepted a salary from Essent that was indeed the writing on the wall.


Fac-p, for the life of me I can't get "salary" in bold type! Help!

Anonymous said...

It makes me wonder, you wade in sh*** long enough, even the smell becomes tolerable. Do the E$$ent employees realize their presents in accepting and working in this
pile makes them part of the pile.
The employer doesnt care, how can the employee care and do so without support from an ungrateful employer. Your shoes still smell the same.


Revise and post as you feel appropriate.

Anonymous said...

9:10pm,
If the board isn't responsible for this mess, then just who is exactly?

In the other cities mentioned, Muskogee,Ok and Weatherford, TX, who made the wise choice, to bring other hospital companies into ther communites, thier boards are responsible..

Paris is OUR town and if we are allowing outside interest to control OUR town, Somehow along the way, someone gave up and allowed it to happen.

Who is going to stand up and take control back? Honorable people admit when they make mistakes, and accepot resposiblity for them.. Then do everything possible to rectify those mistakes.

I know there are people in oue community that have power and influence...why not use it for thr good of the community...

Or are you saying this is a hopeless situation and there is no way out?

Why are we all so fearful to fight for what is right? If we band together we could be a powerful force to make the changes necessary. But it is going to take all of us, united.

I believe in this community..we cannot let someone from tennessee kick us in the teeth.

What they are doing here is wrong...

Anonymous said...

1:48 pm,

So far, one of the best posts seen here in a while.The problem with Paris right now is that the whole city seems to be in a slump. Bickering & infighting at City Hall, the Cotton so-called "racism" case, the general clutter that seems to have plagued Paris- this ain't the town I used to live in.

It's a dirty rotten shame that the boards played puppy and rolled over & peed on themselves when Christus and Essent barked. Obviously, this latest batch will not do- it's time to get a new group of people who want to take back control of their hospital, get rid of the racism flag once aand for all, and take City Hall back from the fools currently running things.

First things first, though, let's start with PRMC. Since the Snooze is obviously taking marching orders from Nashville (have Graxiola and co. sold out as well? Looks that way), they're of little to no help. Word of mouth, Internet contacts, blogs like this one, and some folks with stones to stand up & decide to get the plans in motion to kick out Essent, are what is needed.

Hud's company is a financial train wreck, and it would take either massive govenment funding or a letter from Satan himself to stay in Paris. And he doesn't seem to have the money to do so......his prize cash cow is giving less & less milk, and his reaction is to starve the cow to make it produce more. Don't work in the dairy business, won't work in healthcare.

There are several local docs who have surely written to this blog- good on ya!. What would it take to get the backing to pry Hud loose from this area? What local businessmen are there left who have the future of their hometown so deeply in their hearts that they would join this coalition? How many of us regular citizens would decide that a decent hospital in town beats a trip to Dallas, and join?

The American and Texas revolutions were concieved and started by such backstreet meetings. Who says it can't happen again? That little Chihuahua running Essent? His brain-dead mis-leaders? The Snooze?

****'em........it's time to get mad & take action. Hell, it's been past time.

Anonymous said...

Name a time and a place and I'll be there...Let's start this revolution

Anonymous said...

The fools that have been running things at City Hall is The Gang of Pink. Since they got rid of the long term city manager of 17 + years, they hired a "yes man" who let the gang have any favored treatment they wanted and followed through with long-term Pinky goals of cutting police, fire, water and sewer staff - essential personnel, etc. Of course, we kept the pool open and paid out the kazoo to tear down houses by private contractor - a task that was previously done by prisoners from Bonham state jail that no longer come because Tony pissed off their warden. After ruining city finances by failing to raise the sewer rate as recommended by the consultants in a timely manner, they have proceeded to stop the long-time ongoing water line and sewer line replacement projects, stopped cleaning the ditches, stopped hot-mix overlay of streets, and cut the cops so much that drug enforcement virtually stopped for three years. Yes, now they have the paper backing them to get the reps out who finally had the balls to fire Tony who worked a total of 32 hours a week and lived in Jefferson three days a week. He made fifteen thousand a year more than the previous manager and worked less than half the time and only 4 days a week instead of 7. The same gang of Pink includes the uppercrust who think they are so smart - they helped screw up the hospital too. The former director of utilities alerted them that water loss doubled since the new administration took over because they did nothing to fix things. Now, in a panic, they talk about replacing the entire system. Too dumb for words.

Anonymous said...

dear 9:10,
im not shouting;my caps lock was on and i didnt notice.
you missed my point, the problem with fixing the hospital is money.
when we had a locally owned and operated hospital we could make the decisions; other people now own the hospital and they have bought it with their borrowed $.ERGO:if essent fails we might have a chance to build a new hospital;but that would mean a county tax supported hospital district,are you willing to pay the increased taxes that would entail?i am.

Anonymous said...

There are some many things I enjoy about living in Paris, I feel my children are a little more sheltered out in the sticks where we live.

It is a beautiful area and I have met some wonderful caring people.

What amazes me is the "its all about me" attitude that seems to permiate city hall and quite a few Lamar county citizens...

In a town with a church on every corner, I have not seen more unchristian like behavior, as I have seen here.

And I am sure people are jadded, but inorder to be a community, we have to help out our neighbors. Treat people with kindness and respect and maybe it will be reciprocated.

In the bible it says where mercy is shown, mercy is given. Many of us have lost our way, when it comes to honesty and doing what is good just for me instead of what would be good for everyone.

If you know someone with power and influence here in our community, could you please impress upon them, that it is time for them to give back unselfishly and honorably, to this community.

Lets all do what we can as individuals and get together...to make Paris the town we can be proud of....

Because it is up to each of us....

Anonymous said...

Leaders in the communtiy: (Translated) Those folks in Paris who can't find their asses with both hands, who have screwed up more than they or anyone who might come after them for years can possibly fix.

Anonymous said...

To quote from "The Hitchhiker's Guide to the Galaxy" Essent & the PRMC Board will be "first against the wall when the revolution comes!"

Anonymous said...

10:44,

Nomally taxes are the very last thing the average citizen wants raise. However, impess upon folks that the money from public and private sectors would go towards a better healthcare facility, and folks may jump on board. There is still lots of room on the north campus (which is where Essent was supposed to be building a new facility in two years' time, so they promised). It would take a sales job not seen in this area in a long time, but in a way, you'd have Essent helping you- after all, who want to have crap when you can have better? And actually see where you money is going?

It will not only take money from the loals, but mony from outside investors, to buy back what is rightfully ours- our hospital.

The days of two hospitals in Paris is dead and gone, but the days of one strong, well-run, well-managed facility with a strong local support lie ahead.

I'd pay more taxes as long as I know where and how my money is spent- after all, that is my right.

Anonymous said...

I too, would support a tax increase, in order to take over control of our hospital. It should be a county wide hospital district tax...Hell, I would donate extra money to that fund..
With a few decent grant writers, there is grant money fed and state to fund some of it.