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A New Contest !

Stanley Feld M.D.,FACP,MACE

Did you know there is a new money contest going on in the Boston area? The contest is called “which hospital CEO can make the most money?”

“Hospital CEOs join the $1m club” is exposed in the Boston Globe while nurses are asked to take a salary cut. Union slams big raises, but nonprofits say they’re trying to keep top talent.
Chief executives at charitable hospitals in Massachusetts received substantial pay and benefit increases in fiscal year 2005, for the first time boosting their overall compensation to more than $1 million at most of the largest institutions.

Partners’ HealthCare chief executive James J. Mongan broke the $2 million barrier.
Massachusetts General Hospital chief executive Peter Slavin’s compensation rose 13.1 percent to $1 million, from $884,422.
The package for the chief executive at Brigham and Women’s Hospital, Gary Gottlieb, climbed 6.9 percent to $1 million, from $935,009.
Among other teaching hospitals in the state, Boston Medical Center chief executive Elaine Ullian’s compensation increased 54 percent to $1.37 million, from $885,901. The jump was the result of bonuses worth $425,000, which made her the second-highest-paid chief executive in the state, behind Mongan.
At UMass Memorial Medical Center in Worcester, chief executive John O’Brien’s compensation swelled 38 percent to $1.27 million, from $920,000. The increase included $372,000 in deferred compensation and other benefits.
The Massachusetts Nurses Association, which broadly criticized increased salaries for Massachusetts hospital chief executives, singled out O’Brien for criticism, because during ongoing contract talks for 760 nurses at the hospital’s university campus he has asked them to accept a reduction in pension and healthcare benefits.
At Lahey Clinic in Burlington, chief executive David M. Barrett’s package was up 32 percent to $1.25 million, from $945,031. The increase included $518,000 in benefit payments.
In Springfield, Baystate Health gave chief executive Mark R. Tolosky $1.24 million, up from $1.03 million in 2004, the year he was promoted to chief executive.
Children’s Hospital Boston boosted chief executive James Mandell’s compensation 9.9 percent to $1.07 million, from $978,955.
At Tufts-New England Medical Center, chief executive Ellen Zane received a total of $1.05 million in 2005. In 2004, she was chief executive for just eight months and received $590,131.
Beth Israel Deaconess Medical Center chief executive Paul Levy received a 4.5 percent increase to $1 million, from $957,477.

The CEO turnover rate among the 4,566 hospitals tracked by the American College of Healthcare Executives was 16 percent in 2004.

CEOs are fired or resign. The turnover rate is very high. Perhaps the high paid CEOs in the country have figured out how to make large profits for the hospital system from the dysfunctional DRG system and non profit care profit, while those fired CEOs did not.

Meanwhile, patients in the Philadelphia area have to wait three months to get an appointment to see a Clinical Endocrinologist for their diabetes. The reason is that few physicians are going into Clinical Endocrinology because the payment is too low. There are only 22 Clinical Endocrinologist practicing in the Philadelphia area.

Cognitive services have been experiencing and receiving decreases in payment for the last 10 years. New rules and reimbursement cuts continue to bombard the Internal Medicine specialties and subspecialties. The American College of Physicians, the Internal Medicine specialty group, published a white paper on the demise of Internal Medicine this past year.

At the same time “Hospital Charity Care Is Probed” for abuses by non profit hospitals. A certain percent of care must be given to charity cases in order to maintain non profit status. “Investigators Find Nonprofits Overcharge or Deny Services.”

Is this one of the ways the Boston and Massachusetts non profit hospitals make so much money to enable them to pay the CEOs one million plus dollars per year? We know the loopholes in the DRG system also help.

Where are the American Healthcare Systems priorities? Where is the value? Is it patient care first or the bottom line? The rules and regulation generated in the 50 years since Medicare has resulted in distortions of priorities in the healthcare system. The hospitals and insurance companies are making lots of money from the developed Healthcare System.

Patients, the primary stakeholders, are suffering with decreasing value of medical care and increasing cost. Physicians are experiencing decreases in reimbursement. Many are retiring early or seeking other sources of income.

Patient Power has to act now and demand of state and federal candidates create real Healthcare System and not the Band-Aid for the facilitator stakeholder vested interest reform of the past.

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