with Crossroads Behavioral Healthcare, a North Carolina-based provider of mental health, developmental disability and substance abuse services. More than 100 professionals, including psychiatrists, psychologists, nurses, counselors, social workers and addiction specialists, will become Telecare employees. >>

SBC to Acquire AT&T
SBC Communications Inc. has agreed to acquire AT&T, bringing to the combined company the world's most advanced communications network to meet the sophisticated data communication needs of large businesses with multiple locations. AT&T serves virtually every member of the Fortune 1000. Its global network spans more than 50 countries and connects virtually every country and territory around the world. SBC is an industry leader in high-speed broadband, with 5.1 million DSL Internet lines and a local broadband network covering 77% of its local customer locations.  Meanwhile, Denita Willoughby is transitioning her leadership of SBC's Healthcare Market Group to Jon Wellinger (see bio below). Harvey Livingston and Judi Manis will continue to work with Jon as they manage SBC's Northern and Southern California healthcare markets respectively. >>

Wall St. Journal Outlines Five Innovations to Help Push EMRs
About two-thirds of healthcare providers surveyed by HIMSS say they plan to implement electronic medical-record systems in the next two years. Here are the top five ideas and innovations connected to the push for EMRs that could change healthcare. 
Computerized Physician Order Entry: Though fewer than 2% of hospitals now have the most-advanced versions, there is pressure to adopt systems that require all orders and prescriptions to be entered into a computer. >>
Clinical decision support systems: Software or Web-based programs can offer disease-management guidelines as well as evidence-based recommended treatment plans. Doctors can review the plans online with the patient and tailor the recommended care plan on the basis of their own professional judgment.
Electronic prescribing systems: A range of devices, including wireless PDAs, can send prescriptions directly to pharmacies, look up drug information and medical history, and let doctors know if patients have filled prescriptions. These are being used by about 12% to 18% of doctors at present.
Patient tracking and verification systems: Hand-held PDAs are also being used to electronically record information during checkups and treatment, and scan bar codes to make sure the right medication is being given in the right dose to the right patient. Some hospitals are starting to work with RFID tags that can track a patient around a hospital, and avoid patient mix-ups in treatment and blood transfusions.
National Health Information Infrastructure: Technology companies are working with government and nonprofit groups on a single data standard that will let competing medical record-keeping products "talk" to each other, and link a patchwork of incompatible systems. The aim is to create a "network of networks" that will allow doctors, hospitals, labs, pharmacies and insurers to securely exchange information about patients and track public-health threats. (Wall Street Journal, 2/9/05)

About Half of All Bankruptcies Are Result of Medical Costs
About half of bankruptcies filed in 2001 were because of medical bills, according to a study published on the Health Affairs Web site. Some 46.2% of people cited illness and medical bills as the cause of their bankruptcies. The rate rose to 54.5% when births, deaths and gambling addictions were considered as factors. Seventy-six percent of people who had a medical-related bankruptcy had health insurance when they first became ill. For people filing bankruptcy, out-of-pocket medical costs averaged $13,460 for those who had health insurance, compared with an average of $10,893 for the uninsured, the study says. The highest costs -- $18,005 on average -- were incurred by people who had private health coverage at the beginning of their illness but later lost it. For patients with cancer, average out-of-pocket costs were $35,878. Most of those who filed for bankruptcy because of medical costs were middle-income homeowners. (Chicago Tribune, L.A. Times, AP/San Jose Mercury News & Boston Globe, 2/2/05)

Disease Management Now a $750 Million Industry
Disease management is now a $750 million industry that serves approximately two million Americans suffering from conditions such as cancer, heart disease, diabetes, and osteoporosis, according to US News. (PRNewswire, 1/25/05)  Meanwhile, top executives in the healthcare industry believe greater use of information technology, practice guidelines and patient safety measures, as well as implementation of disease management programs are key to improving quality and containing costs of healthcare in the U.S., according to a survey by Harris Interactive. (PharmaLive, 1/26/05)

Healthcare Costs Cause Millionaires To Put Off Retirement
A new survey of 1,312 people with at least $1 million to invest, not including the value of their residences, indicates that significant assets do not eliminate worries over increasing healthcare costs. The survey, by Northern Trust, says that almost half of employed millionaires plan to continue working at least part-time during their retirement years, a decision in part because of stock market fluctuations. Further, 10% of respondents with $10 million in assets say they do not plan to retire because they said they feel insecure about their financial situations or enjoy working. (Dow Jones/Wall Street Journal, 2/3/05)

Ranks of Hospitalists Growing
The number of hospitalists -- physicians who specialize in caring for inpatients -- has increased from just several hundred in the mid-1990s to more than 8,000 in 2003, according to a new report by the Center for Studying Health System Change. Researchers said several factors, ranging from financial pressures and patient flow to safety concerns and rising malpractice costs, have contributed to the rapid increase in hospitalists. In most of the 12 nationally representative communities studied, most major medical groups use hospitalists for a majority of their admitted patients. (MP Stat, 2/1/05)

Unions Join Hospital-Costs Fight
Fourteen labor unions representing more than 500,000 California workers have joined together to fight rising hospital costs and improve quality. The California Health Care Coalition plans to study prices charged by hospitals and use the information to get a better deal on the healthcare benefits purchased by their union trust funds. The move appears to be one of the broader marketplace's first responses to last year's decision by CalPERS to cut 24 high-cost hospitals out of its Blue Shield network. The Coalition said that the basic problem is that healthcare costs are rising in California at almost twice the national rate -- 11.3% versus 5.9% -- with tremendous regional variation in charges, costs and quality of care. The coalition intends to do further research and create a data warehouse of how the trust funds spend money on healthcare claims. Combined, they hope for better information and more clout in the marketplace to demand accountability and lower costs. (Sacramento Business Journal, 2/7/05)

Rate of Employer-Sponsored Coverage in the State Decreases
About 53.8% of nonelderly California residents received employer-sponsored health insurance in 2003, according to a UCLA Center For Health Policy Research study, a 2.6% decrease from 2001. More than 6.5 million state residents were uninsured at some point in 2003, including about one million children, the study reports. (Sacramento Bee, 2/7/05)

Medicaid Managed Care Provides Cost Savings
Medicaid managed care provides significant cost savings and high quality care, found a new study from the Lewin Group for America’s Health Insurance Plans. Among the highlights of the Lewin analysis: the Medicaid managed care model typically yields cost savings from 2% to 19%; savings are largely attributable to decreases in inpatient utilization; Medicaid managed care programs save between 10% and 15% on the costs of prescription drugs compared to Medicaid FFS; managed care programs improve beneficiaries’ access to services and earn high satisfaction ratings from their enrollees. (Managed Care Weekly Watch, 2/8/05)

"Healthcare Unbound" Expected to Grow Exponentially
By 2015, Forrester Research projects that 60% of all patients discharged after a lengthy hospitalization, 40% of all chronically ill, and 12% of all seniors will adopt healthcare unbound (technologies in, on, and around the body that free care from formal institutions) technologies and services. Forrester's forecast predicts adoption of three types of healthcare unbound solutions: activities of daily living support and elder monitoring, chronic care maintenance, and acute post-hospitalization care management. Each segment will experience unique growth trends during the following three phases: The Era Of Self-Pay: 2004-2008 -- Initial healthcare unbound growth will be fueled by consumers who see a value in paying for healthcare unbound out of pocket, namely affluent chronic illness sufferers and caretakers for sick or aging family members.  The Era Of Validation: 2008-2010 -- Growth will accelerate as healthcare vendors entice third-party payers with studies that prove valuable long-term cost savings from healthcare unbound investments.  The Era Of Third-Party Payment: 2010 And Beyond -- Solid evidence of healthcare unbound's ability to improve healthcare efficiencies will spur third-party reimbursement, sparking rapid adoption of healthcare unbound solutions. (Healthcare Intelligence Network, 2/2/05) 

Medicare to Test Pay-for-Performance with Doctors
The CMS announced its first demonstration project to test pay-for-performance incentives for physicians. Ten large medical groups will participate in the three-year project, which starts April 1. The groups will receive bonus payments, in addition to fee-for-service rates, if they lower Medicare costs while implementing care-management strategies to improve the overall care of beneficiaries with chronic conditions. They also will receive extra money based on how well they meet standards for preventive care to all Medicare beneficiaries. (MP Stat, 2/1/05)  Meanwhile, the University of California in 2004 paid about $2.4 million in bonuses to 65 executives at its five teaching hospitals, according to a report made public by the American Federation of State, County and Municipal Employees. The bonuses averaged $36,000 and 11 executives' bonuses exceeded $50,000. (San Francisco Chronicle, 2/3/05)

Panel To Study Hospital, ED Closures in L.A. County
Assembly Speaker Fabian Nunez (D-L.A.) announced the creation of a special legislative panel to address hospital and emergency department closures in L.A. County. Called the Select Committee on the Los Angeles County Health Care Crisis, the panel will consist of 12 state legislators, and Assembly member Mark Ridley-Thomas (D-L.A.) will be the chair. The committee plans to meet for the first time next month and will focus on the causes of financial and management problems. Panelists also will weigh comments from healthcare officials. (L.A. Times, 1/29/05)

36% of Hospitals Meet Nurse Staffing Requirements
About 36% of California hospitals are in compliance with state nurse-to-patient ratio rules, according to data from DHS from the first 10 months of 2004. (L.A. Times, 2/6/05)

Bush Seeks Boost for HHS
HHS funding would grow 9.9% in fiscal 2006, under President Bush's budget request, to $642.5 billion. Medicare would account for $340.2 billion of the agency's budget -- a $49.9 billion (17.2%) increase over fiscal 2005; Medicaid $192.7 billion -- a $4.2 billion (2.2%) increase; and the State Children's Health Insurance Program $6.2 billion -- a $890 million increase. Discretionary spending would include $2 billion for community and migrant health centers in 2006, an increase of $304 million from 2005. Read the proposed 2006 HHS budget. (MP Stat, 2/8/05)

Drug Program Cost Estimate Rises Dramatically
The new Medicare prescription drug program will cost $325 billion more than originally estimated, according to new figures released by the Bush administration. The cost of the benefit is now pegged at $720 billion over 10 years, up from $395 billion projected by the administration in late 2003. (MP Stat, 2/9/05)

Panel OK'd to Oversee Some Operations at King/Drew
The Los Angeles County Board of Supervisors voted to approve the creation of an independent panel of healthcare officials to oversee patient care and physician residency programs at Martin Luther King Jr./Drew Medical Center. The panel will consist of volunteers with backgrounds in finance, business and hospital management and will report directly to the board of supervisors, bypassing the county DHS. The panel will make recommendations on malpractice claims, expenditures, revenue and compliance with regulations. County DHS will retain authority over purchasing contracts and personnel matters. (L.A. Times, 2/9/05)  Also, JCAHO revoked its seal of approval from King/Drew, which means that many private insurance companies will no longer pay for care there. The loss also jeopardizes some of the doctor-training programs run by the affiliated Charles R. Drew University of Medicine and Science and emergency psychiatric services at the hospital. (L.A. Times, 2/2/05)

Expanded Guidelines Issued on Hospital-Physician Contracts
The HHS inspector general's office has released a 49-page supplemental compliance guidance for hospitals on the Federal Register, updating guidance originally offered in 1998. Regarding hospitals contracting with physicians, it reiterates the IG's cautions in structuring compensation arrangements, encouraging hospitals to fairly and objectively determine the fair market value for pay and services and highlighting the potential for violating anti-kickback and physician self-referral laws. The IG devotes two pages to physician recruiting arrangements, and covers issues relating to medical staff credentialing, gain-sharing and hospital subsidies of medical malpractice insurance premiums for physicians. (MP Stat, 1/28/05)

Adam Darvish, Kindred Hospital - Los Angeles

Adam Darvish is CEO of Kindred Hospital Los Angeles, which offers a full range of services for acute long-term, catastrophically ill patients, featuring intensive care services in five state-of-the-art ICU beds; 24-hour telemetry monitoring; and comprehensive acute-level care in 76 licensed acute-care medical beds. Kindred's patients typically are ventilator- and/or technology-dependent (ie, requiring IV therapy or dialysis), or have medically-complex conditions. Adam has worked for Kindred (previously Vencor) for 15 years, in positions including CEO of Kindred Hospital Seattle; COO of Vencor Hospital Orange County; COO of Vencor Hospital Brea; and Nursing Home Administrator in San Francisco and Burlingame. Earlier, he was a Biomed Engineer and a Biomed Director. Adam has joined the Los Angeles Round Table.

Jon Wellinger, SBC Communications - Healthcare Markets

Jon Wellinger is a Regional VP of Healthcare Markets at SBC Communications Inc.  He is a 25-year veteran in the telecommunications industry and has held numerous sales and marketing positions of increasing responsibility. SBC’s Healthcare Organization sells voice and data products that include high-speed Internet access, data transport, network integration equipment, professional services and basic voice services.  SBC companies serve more than 54 million access lines nationwide. Cingular Wireless, of which SBC is a 60% owner, serves more than 46 million wireless customers in all of the top 100 metropolitan areas. Jon is also joining the L.A. Round Table.