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Hospital Review July 2014 • Vol. 2014 No. 7 INDEX Table of Contents p. 6 CEO Roundtable p. 19 Clinical Integration & ACOs p. 24 Financial Management p. 26 Health Information Technology p. 30 Leadership & Management p. 33 Beyond the Basics p. 36 CEO Roundtable Three leaders who work in some of America's healthiest counties discuss what population health means and looks like to them. p. 19 How 3 Community Hospitals Are Improving Care Delivery Large, multi-state systems aren't the only ones to innovate. p. 30 What it Takes to Build A Price Transparency Tool Patient demands for actionable financial information are on the rise, and hospitals can't ignore it for much longer. p. 27 Integrated Chaos: Health Systems and the Aftermath of Defensive Physician Acquisitions By Molly Gamble When hospitals or health systems explain the reason- ing for their acquisition of other hospitals or physician groups, the language is richly coated in good intentions. These deals are presented as monumental solutions to problems, even though those problems may not have been Too Small to Fail: Why Letting Community Hospitals Die Isn't an Option By Ellie Rizzo What's the mission of a community hospital? The an- swer isn't so simple. While intuition says its mission is to provide care to its community, it also serves on another level. "It's a matter of survival," said Michael D. Williams, FACHE, president and CEO of the Com- munity Hospital Corporation. Alvin Hoover, CEO of King's Daugh- ters Medical Center in Brookhaven, Miss., says his hospital faces a num- ber of fiscal challenges as a rural provider. Bad debt is in the 8 percent to 9 percent range, and last year the hospital delivered about $12 million of uncompensated care. Because of those financial issues, he says it makes sense that Medicare pays his hospital more than ambulatory surgery centers for outpatient servic- es. "If they start paying us ambulatory surgery rates for outpatient surgeries, then we've got some real challenges," he says. "I've got to keep up an emer- gency department that I don't get paid for a lot of the time. Some other ser- vice in my hospital has to supplement the money it takes to pay for that." However, lowering hospital out- patient department rates is exactly what some officials overseeing the Medicare program have called for, spurring a fierce debate with hospi- tals. The Medicare Payment Advi- sory Commission has consistently recommended that Medicare lower its reimbursement rates to hospital outpatient departments, citing the continued on page 8 continued on page 9 continued on page 26 INSIDE: 100 Great Community Hospitals The Outpatient Payment Rate Debate: What Lower Reimbursement Would Mean for Hospitals By Helen Adamopoulos REGISTER TODAY! Becker's Hospital Review CEO Strategy Roundtable November 5, 2014 Ritz-Carlton Chicago, Chicago 40 Hospital & Health System CEOs Speaking Co-chaired by Scott Becker, Publisher, Becker's Hospital Review, and Chuck Lauer, Former Publisher, Modern Healthcare To learn more visit www.BeckersHospitalReview.com To register, visit www.regonline.com/ceoroundtable2014