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5 posts from March 9, 2014

March 09, 2014

How HCA turned trauma into a money-maker as regulators, legislators look away

From the Tampa Bay Times:

Last year in western Pasco County, 16-year-old Mason Jwanouskos was in the backseat of a convertible when his friend lost control and crashed into a stone pillar. He couldn't have picked a more expensive place to get hurt.

If he had crashed 30 miles to the south, he would have gone to one of three trauma centers in Tampa or St. Petersburg. They likely would have charged him about $30,000, their typical charge for patients with a concussion.

But Mason was closer to the trauma center at Regional Medical Center Bayonet Point.

His bill: $99,000.

Mason's uninsured parents were not billed three times more because their son got vastly better treatment. Bayonet Point offers the same kind of care as any state-certified trauma center.

The family's bill was so high because Mason, through no choice of his own, wound up at a trauma center run by Hospital Corporation of America.

An unprecedented analysis of state records by the Tampa Bay Times has found that HCA trauma centers, as a group, are charging injured patients tens of thousands of dollars more than Florida's other trauma centers.

The difference has nothing to do with the level of care provided.

Instead, HCA is capitalizing on a marketplace that is unchecked by politicians or regulators. That has allowed one of the nation's largest for-profit hospital chains to bill injured patients record fees, the Times has found. More here.

'Awful' poll numbers make GOP nervous about Rick Scott's chances


The state of Gov. Rick Scott’s poll numbers is . . . sorry.

On Tuesday, as Scott kicked off the Legislature’s 60-day lawmaking session, he gave the annual state of the state speech, a campaign-like preview filled with job-creation statistics.

But many of Scott’s fellow Republicans were paying attention to a different set of numbers: a raft of poll data-points that make the GOP queasy because it shows Democrat Charlie Crist has broad support across Florida right now. The highlights:

• 34 percentage points — the margin Crist beats Scott by in Broward and Miami-Dade counties, according to one business interest’s statewide survey. This margin is 12 points greater than Democrat Alex Sink’s in the 2010 governor’s race. If she had earned Crist’s poll numbers in just these two counties, Sink would have won.

• 10 percentage points — the margin Crist beats Scott by in another business interest’s statewide poll.

• 8 percentage points — the margin Crist beats Scott by in two other business interests’ statewide polls.

• 7 percentage points — the margin Crist beats Scott by in a fourth business interest’s statewide poll.

• 6 percentage points — the margin Crist beats Scott by in a poll of Republican-controlled state House districts across Florida

More here

Appeal over prehistoric Miami site brings politics into preservation question

@AndresViglucci @NadegeGreen

When developer MDM Group managed to yank away from Miami’s historic preservation board last week the question of what to do with the discovery of a significant prehistoric Tequesta Indian village site, they moved the ball into a potentially more advantageous court — the political, deal-making world of the City Commission.

And, in fact, the negotiating has already begun over the array of carved postholes that archaeologists say likely represent the foundations of a 2,000-year-old village.

Miami Commissioner Marc Sarnoff, whose district includes downtown, summoned MDM attorney Eugene Stearns to his office Monday to urge a compromise that would save the most important archaeological features on the site, both participants said. Sarnoff is also proposing the unusual step of asking the property owners to enter into mediation with preservationists.

But therein lies the rub: Who gets to decide what those “important” features are, how they’re best protected and displayed, and what would be destroyed and re-buried? And who would enforce those decisions?

More here.

Pay-to-play medical training in Miami worries critics


The breakup came unexpectedly and without explanation.

After years of partnering with Jackson Memorial Hospital, Miami Dade College was tersely informed that its medical ultrasound students would have to find someplace else to train. Jackson would no longer provide the hands-on instruction students needed to graduate.

Behind the scenes, Jackson was being aggressively courted by a fast-growing for-profit school: Dade Medical College. Dade Medical lacked MDC’s long track record and strong academic reputation, but it was willing to do something the public school could not: pay for access.

In 2010, Dade Medical and Jackson signed a deal that paid the hospital $7,500 for each ultrasound student training spot. To date, Dade Medical has paid the hospital more than $330,000.

As a state-funded community college with a tight budget, MDC couldn’t compete, said Medical Campus President Armando Ferrer — at least not without hiking tuition costs. A two-year ultrasound degree at MDC costs about $8,500. A similar degree from Dade Medical runs $47,050.

“Basically we cannot afford to pay for clinical sites, because we would have to pass that on to our students,” Ferrer said. “We try to maintain the lowest cost that we can, with the highest quality.”

MDC’s experience reflects an emerging education and healthcare concern: With a growing number of health-related colleges, many of them for-profit, competition for essential training spots has become increasingly fierce. In nursing, the Florida Legislature directly encouraged this heightened competition, thanks to laws passed in 2009 and 2010 that made it easier for colleges to get new nursing programs approved.

More here.

Common Core opponents put pressure on Scott

State Education Commissioner Pam Stewart is moving full steam ahead with Florida Standards, the new education benchmarks based on the Common Core State Standards.

But Common Core opponents aren't giving up the fight. 

One group, Florida Parents Against Common Core, plans to protest Sunday afternoon, outside a private fundraising event being held for Gov. Rick Scott on Jupiter Island.

"Our intent is to send a loud and clear message to the governor and leadership," the organizers of the protest wrote in a press release. "We want HB 25 and SB 1316 to be heard in the education committees. Committees will only be meeting for two more weeks and time is of the essence."

HB 25 and SB 1316 seek to prohibit Florida from fully implementing the new standards.

Neither proposal seems to be getting any traction, though the Senate bill by Sen. Greg Evers, R-Pensacola, has picked up two additional co-sponsors: Republican Sens. Alan Hays, of Umatilla, and Lizbeth Benacquisto, of Ft. Myers.

The House bill by Rep. Debbie Mayfield, R-Vero Beach, now has six co-sponsors: Republican Reps. Ray Pilon, of Sarasota; Travis Hutson, of Elkton; Matt Caldwell, of Lehigh Acres; Charles Van Zant, of Keystone Heights; Dane Eagle, of Cape Coral; and Doug Broxson, of Midway.

The Sunday protest is scheduled to take place near the home of Julie and Amin Khoury, who are hosting roundtable discussion and barbecue to raise money for Scott. 

Common Core opponents also plan to demonstrate in Tallahassee on March 13.

The planned protests come just weeks after the Republican Party of Florida Legislative Affairs Committee took an official position that the state ought to cease further implementation of the Florida Standards.

The group is encouraging Scott to take executive action if the Legislature does not act.

State education officials are moving forward with the standards anyway. 

Stewart has said she will select a vendor to create state assessments based on the Florida Standards this month.