Healthcare Roundup: Wal-Mart Steps Forward, Ryan to Step Down, Novant Expands to Virginia, and More

Last Updated Jul 3, 2009 3:21 PM EDT

Wal-Mart Steps Forward â€" Wal-Mart Stores, the nation's largest retailer, has endorsed the idea of an employer mandate to cover workers, with three caveats: it must be part of larger health care reforms, it must exempt small firms, and it must allow employers to offer the kind of basic coverage that Wal-Mart provides to its workers. Currently, 95 percent of Wal-Mart employees have insurance either through the company, their spouses, or the government, and Wal-Mart itself covers more than half of its workers. The big retailer, which took flak over its health coverage several years ago, has in the past opposed efforts by states to require large employers to cover their workers. Its current stance diverges from that of the National Retail Federation, but some big companies favor a mandate to level the playing field with firms that don't offer health insurance. [Source: Washington Post]

Sister Ryan to Step Down â€" Sister Mary Jean Ryan, long acknowledged as one of the most powerful healthcare executives, is starting her transition to retirement. Ryan, 71, has been president and CEO of SSM Health Care, one of the largest Catholic healthcare systems in the U.S., since its founding in 1986. Starting Aug. 1, she will become chair and CEO, and William Thompson, now senior vice president for strategic development, will become president and COO. The plan is to have Thompson take SSM's reins over the next 18 to 24 months. [Source: St. Louis Business Journal]

Novant Expands Its Reach â€" Despite losing money last year, Novant Health has completed its merger with Prince William Health System in the Washington, DC, suburbs. Novant, based in Winston-Salem, NC, is one of the nation's largest integrated healthcare networks. The Prince William deal marks an expansion beyond its North Carolina hospital base, although it has other facilities in 13 states. Having received the blessing of the FTC and Virginia's Attorney General for the merger, Novant plans to invest $240 million in Prince William to help meet the needs of the growing local population. [Sources: Novant, Washington Business Journal]

Anthem Requests Giant Rate Increase â€" Anthem Blue Cross and Blue Shield is seeking approval from regulators in Connecticut for rate increases on individual insurance averaging 23 percent. Blaming higher claims costs, Anthem asked for the rate hikes to take effect on Oct. 1, instead of Jan. 1, when rates usually go up. While it's hard to understand why Anthem is asking for twice as high an increase as Aetna is in Connecticut, the huge insurer is not the only one jacking up premiums in the individual market. Michigan Blue Cross and Blue Shield on June 20 asked for an immediate rate hike of 44 percent for non-group policyholders. One wonders why policymakers in Washington are not paying closer attention to these events. [Sources: Hartford Courant, Detroit Free Press]

Outpatient department update â€" CMS will pay both hospital outpatient departments and independent ambulatory surgery centers (ASCs) 1.9 percent more next year. More than 4,000 hospitals and other facilities will receive $31.5 billion in 2010, CMS estimates, compared with $28.7 billion in 2009. The estimates are possible because CMS pays outpatient facilities under the outpatient prospective payment system. Medicare will expand the number of procedures covered in ASCs, which are expected to receive $3.4 billion in 2010. [Source: Modern Healthcare]

  • Ken Terry

    Ken Terry, a former senior editor at Medical Economics Magazine, is the author of the book Rx For Health Care Reform.