Becker's Hospital Review

38 In the News BECKER'S HOSPITAL REVIEW CEO REPORT E-WEEKLY free • educational • up-to-date Visit beckershospitalreview.com/e-weeklies.html or call (800) 417-2035 subscribe today DOJ Sues Michigan Hospitals for Alleged Antitrust Violations By Ayla Ellison When is a Surgeon Too Old to Practice? By Emily Rappleye T he American Medical Association, which voted to develop guidelines and tests to ensure older physicians can still safely treat patients, reports now one in four physicians in the U.S. is over 64 years old. ere is no age cutoff for physicians. Yet as the number of senior physicians grows rapidly, many are beginning to ask, "How old is too old?" Old age and the fatigue, forgetfulness and worsened eyesight that oen come with it are especially at issue for surgeons, as an NPR report highlighted. Of all physician specialties, surgery requires fine motor skills, fluid thinking and endurance. "I think the general public would be very interested to know that [surgeons] don't police [themselves] well as a profession," Mark Katlic, MD, a 63-year-old surgeon at Baltimore-based Sinai Hospital, told NPR. "It oen takes a bad com- plication that hurts a patient before something serious is done." What makes retirement cutoffs difficult is there really is no one age at which surgeons should retire, and it depends entirely on the individual. Because of this, many hospitals and health systems beat AMA to the punch and already implemented guidelines and tests for their surgeons, according to NPR, such as "e Aging Surgeon Program," which was created by Dr. Katlic at Sinai Hospi- tal, or the "Late Career Practitioner Policy" at Stanford (Calif.) Health. However, no surgeons have volunteered on their own to enter e Aging Sur- geon Program and the Late Career Practitioner Policy has met some backlash from physicians, according to NPR. n Moody's: Distressed Non- profit Hospitals to Elevate M&A By Emily Rappleye M oody's Investors Service predicts merger and acquisi- tion activity will grow and remain elevated for at least two years as financially distressed nonprofit hospitals seek solace in consolidation to avoid payment default. Small hospitals with revenues of $500 million or less are most likely to be affected, according to Moody's. ese providers are facing increasing regulatory and financial changes, leading to increased consolidation with larger, oen for-profit hospital operators, which have been buffered from change by economies of scale. Nonprofit hospitals have declined from 80 percent market pen- etration in 1999 to 73 percent penetration in 2003, according to Moody's, and, M&A volume in the first quarter of 2015 and fourth quarter of 2014 show the first significant transaction growth since 2012. Moody's also notes M&A growth will result in increased proposed transactions that fail to close. "For small distressed hospitals, the inability to execute a consolidation strategy increases the probabil- ity of a payment default or bankruptcy filing because of the expen- diture of time and limited resources spent analyzing the merger or acquisition," according to a Moody's report. n T he Department of Justice sued four Michi- gan hospital systems in late June, alleging that for years the systems had unlawfully allocated marketing territories to limit competi- tion. e complaint was filed against the following or- ganizations: Hillsdale (Mich.) Community Health Center; Community Health Center of Branch County in Coldwater, Mich.; ProMedica Health System in Toledo, Ohio; and W.A. Foote Memo- rial Hospital in Jackson, Mich., doing business as Allegiance Health. With the exception of Al- legiance, all of the organizations agreed to settle with the government the same day the claims were filed. e government alleges Hillsdale curtailed com- petition by entering into agreements with Al- legiance, Community Health Center of Branch County, and two of ProMedica's facilities — Bixby Hospital in Adrian, Mich., and Herrick Hospital in Tecumseh, Mich. — that limited marketing of competing healthcare services. "Instead of putting patients first, these hospitals secretly agreed not to compete," said Assistant Attorney General Bill Baer of the Justice Depart- ment's Antitrust Division. e DOJ settlements terminate the agreements the organizations had in place and prohibit Hillsdale, Community Health Center of Branch County and ProMedica from agreeing with other healthcare providers to limit marketing or to di- vide any geographic market or territory, accord- ing to the DOJ. As of July 1, the government was continuing to pursue claims against Allegiance. n

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