VOL. 37, NO. 7
FEBRUARY 15 - 21, 2016
Focus
TECHNOLOGY: Online orders A convenient way to buy groceries
Who to Watch
P. 4
We honor some of NEO’s brightest in health care
LEGAL: More mergers Practice is picking up at law firms
P. 17-21
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CLEVELAND BUSINESS
REAL ESTATE: On the move Mars Electric finds a new home P. 7
The List Region’s largest philanthropic gifts P. 27
Untangling your hospital bill Local systems seeing benefits of bundled payment model
GETTY IMAGES
By Lydia Coutre
A new national contract could bring hundreds of patients from across the country to St. Vincent Charity Medical Center for bariatric surgery. The draw? A new and growing payment model that links historically siloed charges into one bundled payment, incentivizing providers to keep costs down, giving insurance companies and patients an expected price tag and potentially improving quality of care. Bundled payments may be a solution to what Tom Campanella, director of the health care MBA program at Baldwin Wallace University, calls one of the biggest challenges in health care: fragmentation. A surgery in a hospital can mean several separate charges: one for the surgeon, another for the anesthesiologist, a pathologist or emergency room physician if they’re involved, then the rehab, occupational therapy, and on and on. “The analogy I would use is a balloon,” Campanella said. “You have
all these different parts, and even if you squeezed down on one, the other side would pop up from a cost standpoint. So now they’re saying let’s wrap all of that together in a bundle.” Bundled payments have an agreed-upon price tag. Any money not spent below that target is savings for the hospital, but overspend and the hospital pays. Several Northeast Ohio hospitals have been piloting the bundled payment model through the Centers for Medicare and Medicaid Services. As CMS begins to see the benefits of bundled payment, officials expect to see the approach more and more in the commercial industry, such as the contract St. Vincent landed. Already, third-party vendors to negotiate bundled payment contracts between hospitals and insurers or employers are emerging, Campanella said. “It’s moving like crazy,” he added. St. Vincent was selected through a SEE HOSPITAL BILL, PAGE 9
COSE undergoing shakeup Some staff have left organization; others have joined GCP BY JAY MILLER jmiller@crain.com @millerjh
Between now and its annual meeting on Feb. 24, the Council of Smaller Enterprises will tell members about a shakeup underway at the 43-year-old small business support group. What appears to be a restructuring includes a closer integration of COSE with the Greater Cleveland Partnership, its parent organization. Many of the COSE staff that handled marketing, membership development and government advocacy are moving over to the staff of similar GCP
units. In the process, it appears that about 20% of the former COSE staff have left the organization in the last year. The leaders of COSE and GCP declined to be interviewed by Crain’s Cleveland Business about the changes but issued the following statement via email: “Like any successful business or organization, chambers of commerce must adapt and be nimble to continue to meet the needs of our members in an evolving market. We will soon be updating our members on some organizational enhancements, but it would be inappropriate for us to talk to the media about those changes
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before communicating with our members.” No current or former employees contacted were willing to discuss the changes on the record. But some members and several current and former employees and contractors were willing to discuss anonymously what they are seeing. “It’s long overdue,” said a current employee, who declined to speak on the record without approval from top management. “It’s now time for us to evolve a little bit.” Another former COSE worker, who has followed the job reassignments, said, “I think this is the direction COSE is headed — less autonomy SEE COSE, PAGE 8
Inside: Business of Life Paper florist has Source Lunch: proven to be ‘a hit’ Cassi Pittman P. 22-23
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