BWC Postpones Implementation of DRG Reimbursement Methodology

The Ohio Bureau of Workers’ Compensation (BWC) is postponing the implementation of its diagnosis-related group (DRG) reimbursement methodology, according to a letter sent to OHA this week from BWC medical director Gregory Jewell, M.D. BWC’s original target date of Oct. 1, 2006 has been changed to Nov. 1, 2006.

The bureau has completed many of the tasks for this plan, including the rulemaking process, policies and procedures for implementation and most of the information technology requirements to implement the methodology, but it has not completed the testing of the bill payment system. Hospitals must continue to submit bills to the managed care organization (MCO) responsible for managing the injured worker’s claim. For more information on the postponement, see BWC’s letter at www.ohanet.org/advocacy/state/issues/letters/DRGletter.pdf. (Charles Cataline, charlesc@ohanet.org)

Board Moves Full Steam Ahead on Community Benefit Report

At its Sept. 15 meeting, the OHA Board of Trustees directed OHA staff to issue a statewide community benefit report yet this year with statewide aggregate, rather than hospital-specific data. In addition to economic impact statistics, OHA’s report will include charity care, Medicaid losses and community activities in a total statewide community benefit figure and will note hospitals’ Medicare losses and bad debt to capture the full scope of hospitals’ uncompensated care. This change aligns with the Catholic Healthcare Partners/VHA, Inc., guidelines and is consistent with the American Hospital Association’s concerns. The report could be issued as early as next month.

Democratic gubernatorial candidate Ted Strickland and Republican gubernatorial candidate Ken Blackwell addressed the Board at its dinner and meeting, respectively, on key issues facing Ohio and health care in the state. A complete analysis of both gubernatorial candidates’ responses will be available in the September issue of OHA HealthBeat.

The Board approved OHA's participation in public forums scheduled by the governor on specialty hospitals and authorized staff to work with state officials to develop a clear definition of "hospital.”

The Board reviewed 12 principles on pay-for-performance. A small group of the Board will incorporate suggested additions to the principles for Board review at its October meeting.

Staff also provided the Board with updates on the Sept. 13 hearing “Taking the Pulse of Charitable Care & Community Benefits at Nonprofit Hospitals” called by Sen. Charles Grassley, chair of the Senate Finance Committee; OHA’s litigation against the state in conjunction with the failure of Personal Physician Care, a Medicaid managed care plan, which now heads into a mediation process; and the project to explore a federal waiver for a hospital-physician demonstration project on hospital-physician alignment. (Jim Castle, jimc@ohanet.org)    

Hospitals’ Heartbeat

A 2006 nominee for the Albert E. Dyckes Health Care Worker of the Year Award

Kathleen Dieffenbaugher, RN, BSN

Staff Nurse, Critical Care Unit

Genesis HealthCare System

Zanesville

A look inside Kathleen’s nomination –

Her heart is in nursing. That statement sums up the reason Kathleen Dieffenbaugher, B.S.N., R.N., was an excellent nominee for the Albert E. Dyckes Health Care Worker of the Year Award. Nominated by her peers and selected as the Genesis HealthCare System 2005 Nurse of the Year, Kathleen is a consummate critical care nurse with a heart of gold. Her compassion and desire to help others combined with excellent clinical skills, expert knowledge and leadership ability make her a role model. She is on the front line each day helping patients and their families through difficult times. From hands-on clinical care to the caring touch of her hand – Kathleen sees every facet of her job as important to improving the health and lives of others.