ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Sunday, February 4, 1996 TAG: 9602050082
SECTION: VIRGINIA PAGE: C1 EDITION: METRO
DATELINE: RICHMOND
SOURCE: MARIE JOYCE LANDMARK NEWS SERVICE
THE GENERAL ASSEMBLY will evaluate the usefulness of an organization that rates health care services.
Over the past year, a state watchdog agency has revealed what hospitals in Virginia charged for operations and how much money nursing homes made on their residents.
It evaluated how much charity care each facility provided. It showed which facilities were losing money. And it disclosed the profits that nonprofit health care operations made from related commercial enterprises.
Did anyone care?
That's a question before the General Assembly. Legislators are considering a bill - still in discussion at the committee level - that would close the watchdog agency. The bill would give its duties to a quasi-private group that would eliminate most of the reports and charge hundreds of dollars for the information the agency puts out now.
Hospitals and nursing homes want the watchdog agency, the Health Services Cost Review Council, shut down.
The bill has attracted almost no attention outside the health care and business communities. But it could affect how much information consumers can get.
The agency's books and pamphlets offer specifics about the finances and staffing of health care institutions, including:
* Hospital and nursing home charges, what the facilities make per person, and what their cost is to care for that person.
* Staffing levels.
* Analysis of each facility's debt compared to its assets.
* How much charity care the facilities provide and how much of their business is treating poor people on Medicaid.
* How much nonprofit, tax-exempt health care companies make on for-profit affiliations and sister companies.
The information is often publicized by newspapers and television. But that attention doesn't necessarily mean the information benefits consumers, critics say.
``The question is, `What useful information is contained in these reports that help consumers make more informed health care choices?''' said Katharine Webb, senior vice president with the Virginia Hospital and Healthcare Association, which conducted a survey last summer about consumers' interests.
Patients care more about hospital staffing and technology than cost, according to the survey. People seeking a nursing home for a family member look first at environment, staffing and location, the survey found.
``Cost is about the third or fourth issue they look at,'' said Marcia A. Melton, from the Virginia Association of Nonprofit Homes for the Aging. ``No.1 is: `Are they going to take care of Mom and Dad the way I want?'''
Other objections from hospitals and nursing homes include:
* The health care companies whose costs most worry consumers
- insurance companies - aren't covered by the Cost Review Council.
* The pamphlets about hospital charges don't reflect what people actually pay, since government programs such as Medicare pay a set fee regardless of the charge, and insurance companies negotiate their own rates.
Patients rarely choose their own hospitals, Webb said, going instead to the hospital where their doctors work. But one local health official believes consumers do care about finances and profits.
``The public has a right to know what hospital profits are, how much charity care, etc.'' said Paul M. Boynton, executive director of the Eastern Virginia Health Systems Agency, a group that regulates hospital and nursing home expansions in Hampton Roads.
The sponsor of the bill to shut down the council, Del. Jay DeBoer, D-Petersburg, is chairman of the legislature's Joint Commission on Health Care. He received the largest campaign contribution of any candidate from the hospital association last year.
DeBoer said he supported the watchdog group and objected to an attempt last year to shut it down.
But he changed his mind when he saw information collected by his staff that showed low public interest.
The council "may be putting out very good data, but no one is using it,'' he said. ``It's like the manufacturers of button hooks and sealing wax finally seeing the writing on the wall.''
The duties of the watchdog council, which receives no state funding, would go to a Richmond group called Virginia Health Information, a public-private partnership established several years ago.
Like a public agency, VHI gets most of its money from the state. VHI now receives $300,000 in state funds annually.
Health care groups must report to it, and, under the proposed new duties, it would have the authority to charge hospitals and nursing homes a processing fee for collecting the information.
It's controlled by a 17-member board. Three are members of the hospital association, which is the largest single block. Unlike the council, whose board is appointed entirely by the governor, VHI's board is appointed mostly by hospital, doctor, insurance and business groups.
VHI collects data about the types of cases admitted to hospitals, producing reports about demographics, illnesses and costs. Technically, the reports are available to the public - anyone who wants a year's worth of information must pay $3,000 to $3,500, depending on what type of computer medium holds the information.
Businesses that want to use the information for commercial purposes pay much more.
And the reports are sold in computer formats, not paper copies.
So far, the group hasn't used the information for anything free to the public. But Michael T. Lundberg, executive director of VHI, said his group eventually will create reports for public consumption, such as a release this spring on Caesarean sections and possibly a report on what types of injuries are responsible for most emergency room visits.
They hope to give out the reports free in libraries, doctors' offices and other convenient places.
VHI, he said, is not bound by the same state freedom of information laws that require public agencies to release data for the cost of copying. And although VHI makes the information available to government agencies, those agencies must sign an agreement that they won't give it away, he said.
If VHI takes over all the functions of the public Cost Review Council, it likely will dump most of council's public reports, including the pamphlet comparing hospital costs and the information about non-profit groups' money-making companies.
It would continue to produce an annual report on hospital and nursing home finances. But whether that information would be given to the public at cost is uncertain. Lundberg, DeBoer and Webb of the hospital association said they believe this report would continue to be given free to the public.
LENGTH: Long : 121 lines KEYWORDS: GENERAL ASSEMBLY 1996by CNB