Changes Coming to Downtown Louisville for KentuckyOne Health.

Not so bad so far!

I have been scanning the usual media outlets for some clue about what went on at the Tuesday institutional town meetings that Jewish Hospital announced publicly last week. I am finding nothing, nor have I any idea what was discussed.  I have a feeling that if something big had been revealed, that we would have heard of it by now. KentuckyOne and the University of Louisville continue to keep the lid on pretty tight.

What I did find was a YouTube video message from KentuckyOne’s CEO, Ruth Brinkley. It contained nothing particularly surprising or controversial. Its principal function appeared to be to calm employee anxieties that arise naturally during rapid institutional change. It begins by telling the “good news” that half of the $218 million budget deficit has been made up through the hard work and sacrifice of employees, although no details are offered. It restates the obvious, that major change takes time and is difficult. Employees were told that no further large-scale layoffs were anticipated.

Patient referrals and provider recruitment.
Other successes announced include increased referrals to system physicians and mid-level primary care providers through the “Anywhere Care” tele-health initiative or from referrals through HealthGrades. Fifty-eight new primary care providers of a variety of professions have been added to the network.

Employees are told they can help by speaking well of and conveying their pride in the organization to their family and friends. They are urged to select KentuckyOne primary care providers. Suggestions for cost-saving measures from employees are solicited with special recognition awarded for measures that are adopted. Much of the rest of the message is a restatement of the goals of the organization including improving the health of Kentuckians. It is noted that the challenges still facing KentuckyOne are not unique to it. [I agree.] Continue reading “Changes Coming to Downtown Louisville for KentuckyOne Health.”

1964 Civil Rights March on Frankfort Redux.

separare-never-equal 50 years later, still marching for voters’ rights.

Yesterday, along with thousands of others and 50 years too late, I went to Frankfort to participate in a celebration of the 1964 March on Frankfort. Ironically, and belying the opinion of some on the US Supreme Court who must willfully be wearing blinders, the principal issue of protest yesterday was of voting rights– the restoration of suffrage to felons who have paid their dues to society. Many in the huge crowd also carried signs protesting the Commonwealth’s intention to appeal last week’s Federal Court decision requiring Kentucky to recognize legal out-of-state same-sex marriages.

Innumerable signs carried by the crowd recognized heroes of Kentucky’s”s civil rights movement and identified current obstacles to full implementation of basic civil rights for all citizens. These tangible aspects of the march are symbols of the slow but inexorable progress towards the ideals that underlie American culture, but which were imperfectly implemented by the first version of our Constitution. I was even more moved however, by unexpected portents that arose along the route of the march. Continue reading “1964 Civil Rights March on Frankfort Redux.”

QCCT Funding for Indigent Care: Back in Play Again.

Massive Cut Proposed in State’s Biennial Budget for Indigent Care in Jefferson County. Time for a new game-plan?

I knew I was going to have to write something more about the Quality and Charity Care Trust (QCCT) when I saw that the Governor’s budget was slated to decrease the annual appropriation substantially from $21 million to $9.5 and $6.15 million in fiscal years 2015 and 2016 respectively. That represents a 70% reduction and would surely be a body blow to University of Louisville Hospital.

I am unaware of the rationale behind the proposed reduction, but together with the decreasing contributions from the city of Louisville, it is clear that our state and local legislators are rethinking the appropriateness of the QCCT funding mechanism as the principal means to support the care of medically indigent of our community. I have argued that they are correct to do so.

The QCCT fund to support inpatient care at a public University of Louisville Hospital may have made sense in the early 1980’s, but I do not think it does any more.  Much has changed, including the amount of funding and the rules regarding its use.  Our healthcare providers and our community itself have also changed. This was never a funding system that should have been considered to operate in perpetuity. Perhaps the Governor’s Office knows something that we do not. Continue reading “QCCT Funding for Indigent Care: Back in Play Again.”

UofL Hospital Cuts Some Clinical Services.

A significant loss to the community or not?

On Aug 1, the Courier-Journal’s hard-working Laura Ungar reported that the University of Louisville was cutting some services available to its hospital patients. The digital version of the report was quickly picked up by national media. Ashok Selvam, a reporter for the industry news magazine, Modern Healthcare, could not elicit comment from the Hospital itself. His story gave the impression that the cuts were a consequence of last December’s failed merger with Catholic Health Initiatives. It seems to me that such an interpretation is exactly the story line that UofL has been using as it maneuvers to finally consummate such a marriage. Additionally, UofL has been forecasting reduced services to the indigent for many months as it argues before the Louisville Metro Council for additional public funding. Without some actual cuts in evidence, such promises might appear hollow. Given its claims of poverty and need for more tax dollars, I am not surprised that UofL might want to provide some kind of evidence that the sky really might be falling in.

Fortunately for Louisville, Ms. Ungar was very successful in eliciting more information. Despite the fact that UofL President Ramsey recently went out of his way to say that he makes it a point not to read the Courier-Journal, the Hospital would have lost much local credibility if it had stonewalled. So, what were the actual services that are said to be cut, and how might they be related to a failure of the merger or to the provision of indigent care? I must say that I agree with the comment from the Louisville Mayor’s office that “it appears these services are not critical.” Lets take a look ourselves. Continue reading “UofL Hospital Cuts Some Clinical Services.”