[MLUG - DISCUSSION] Re: [MLUG] mlug?

[Jonathan King <EMAIL:PROTECTED>]

[now this in discussion]

On Mon, 9 Dec 2002, Stephen Montgomery-Smith wrote:

> Jonathan King wrote:
> 

[snip]

> > >These are the same people who control the hospital, which
> > >according to a recent state audit, lost about $12M over 2.5
> > >years, because they did not file insurance claims in a timely
> > >manner, or properly preauthorise treatments.
> >
> > Well, that's a point simultaneously about the weakness of some IT or
> > business systems in the hospital, and the real chaotic nature of
> > getting indigent care claims properly filed. ............ 
> 
> As I understand it, the problem isn't so much that this
> happened, rather that the upper adminstration had been told
> repeatedly that this was a problem, and they didn't do a thing
> to correct it.

OK, that sounds depressing but fair enough.  Or maybe PeopleSoft was 
supposed to correct this. :-)

> > replacement) or buying Columbia Regional without a really clear idea
> > of why you needed this facility.  (Apparently, they thought that
> > Boone would scoop it up if they didn't; now, of course, Boone is
> > going to build their own new infrastructure, and Regional looks like
> > a real white elephant in this market.)
> 
> According to the state audit, the University hired an outside
> consultant about whether they should buy Regional.  The
> consultant suggested a price, but said that the University
> should not buy Regional at any price unless the University
> adminstration would then institute major and important
> management changes.  Well, the University went and bought the
> hospital, and then totally failed to institute any of the
> required management changes.

Actually, I believe the one big Amazingly Important (but tricky to
do) change was to unify the Medicare/Medicaid billing across the two
hospitals (which requires some approval process).  Without that, 
they were toast.  The rest of it was just more spreading jam all 
over themselves. :-)
 
> There was an article written by Dr. Adelstein in the Tribune a few 
> months ago, which gave other examples of severe mismanagement of the 
> hospital.  All medical staff I have spoken to say that the article was 
> accurate - if anything it understated the case.  You can find the 
> article on the Tribune web site - I could try to dig it up.

I actually read that one.  Pretty harsh stuff:

http://archive.showmenews.com/2002/apr/20020414comm063.asp

The weakest part of the piece is the suggestions at the end. Some of
them are content-free (e.g., "Value our most important asset: the
employees" is really Dilbert-esque), others are debatable (hire a
dictator and give him sweeping powers), and the biggest problems
aren't the top bullet uncontroversial points, which would appear to
be:

* fire the current leadership (done!)

* fix the billing and service problems

* offer better financial incentives to the best people who were 
  leaving.

So we'll see how it works out.  This is a tough environment for any 
teaching hospital, but obviously Mizzou is in a deeper hole than 
they should be...

jking


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