Becker's Hospital Review

20 CFO / FINANCE UHS Hospital in Oklahoma Faces Medicare Termination on Heels of Buzzfeed News Investigation By Ayla Ellison T ulsa, Okla.-based Shadow Mountain Behavioral Health System, which is owned by King of Prussia, Pa.-based Universal Health Services, is at risk of los- ing its Medicare contract Aug. 24, according to Tulsa World. Shadow Mountain will also lose three of its Medicaid contracts on July 31. CMS said in a May 26 letter to Shadow Moun- tain that deficiencies at the hospital limit its "capacity to render adequate care and prevent it from being in compliance with all the ap- plicable Medicare Conditions of Participation for hospitals," according to the report. CMS said Shadow Mountain is not in com- pliance with Medicare rules related to patient rights, governing body and special provisions that apply to psychiatric hospitals. Although the hospital can maintain its Medicare con- tract by correcting the issues identified by CMS, it may not have the same opportunity regarding certain Medicaid contracts. e Oklahoma Health Care Authority sent a four-sentence letter to Shadow Mountain June 1, indicating it will terminate three of the hospital's Medicaid contracts July 31. "OHCA's decision to terminate Shadow Mountain's contracts without cause with a 60-day written notice is not appealable," the letter stated, according to Buzzfeed News. In a statement to Tulsa World, Shadow Moun- tain CEO Mike Kistler called OHCA's action "unwarranted." "We are hopeful that we will be provided the opportunity to open a dialogue with OHCA ,which will allow us to demonstrate the qual- ity of the care and treatment provided to our patients as well as the vital role we play caring for the residents of Oklahoma with signif- icant mental health issues," Mr. Kistler said. In addition to the action taken by OHCA, the Oklahoma Department of Human Services will no longer send foster children and youths to the hospital, according to Tulsa World. e Medicare and Medicaid termination let- ters come aer Buzzfeed News reported in December that UHS psychiatric hospitals kept patients longer than necessary and against their will to maximize reimbursement from insurers. e report, which was based on a yearlong investigation, also raised ques- tions about the quality of care provided at the psychiatric hospitals. In a press release issued in response to the BuzzFeed News story, UHS denied the conclusions drawn by the reporter. UHS said the story "misses the mark in several import- ant ways leading to an inaccurate portrayal of UHS's behavioral health operations." In May, Buzzfeed News reported an investiga- tion into billing practices used by UHS psy- chiatric facilities broadened to included the FBI and Department of Defense. n 300+ Hospital Executives Tell Their No. 1 Financial Strategy By Kelly Gooch H ospitals cited "reviewing and optimizing current operational and clinical processes" as their top strategy for containing costs in the next three years, according to a survey of U.S. hospital executives. The survey, conducted by Economist Intelligence Unit and sponsored by Prudential Retirement, took place last Janu- ary and February. More than 300 hospital executives par- ticipated. Here are six survey findings. 1. Seventy-eight percent of respondents said rising health- care costs are a "critical" or "extremely critical" concern. 2. Respondents cited various strategies for containing costs in the next three years. Thirty-eight percent of respondents cited "reviewing and optimizing current operational and clinical processes" as their top strategy, followed by "elim- inating unprofitable services" and "seeking lower-cost sup- pliers for inputs," according to the survey. Twenty-nine per- cent of respondents cited "partnering with other hospitals/ hospital groups to create economies of scale" as their top strategy. 3. The survey found more than half (58 percent) of hospitals are adopting at least one of the following strategies: "out- sourcing services," "restricting pay increases" and "chang- ing care pathways to lessen the need for high-cost talent." 4. Half of respondents said merger and acquisition activity or increased partnerships is a viable strategy for eliminat- ing expenses in the next three years. 5. Less than half (45 percent) of respondents said cost is their second-highest barrier in the shift from fee-for-service to value-based care. 6. In the next decade, nearly all (more than 90 percent) of respondents believe they will see a deficiency of special- ists, generalist physicians, nurses and other clinicians "that will hamper their ability to deliver high-quality care." n

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