- The Washington Times - Friday, September 26, 2003

The chief executive of George Washington University Hospital says the District’s health care alliance is failing and threatened to pull his hospital out of the private-public pact that provides medical assistance for the city’s poor.

Daniel P. McLean, who also is chairman of the D.C. Hospital Association, said D.C. Mayor Anthony A. Williams erred in his $500 million plan to privatize healthcare for low-income residents by relying on bankrupt Arizona-based Doctors Community Healthcare Corp.

“It’s had a disastrous effect on the delivery of healthcare and the city has yet to admit it,” Mr. McLean said of the alliance.

Mr. McLean’s criticism comes as George Washington and other D.C. hospitals renegotiate their alliance contracts with city officials. The alliance, which also includes specialists, clinics and independent practitioners, was created by Mr. Williams after the closing of District-operated D.C. General Hospital in 2001.

George Washington, Children’s Hospital and doctor-owned Greater Southeast Community Hospital were part of the original alliance in 2001. Washington Hospital Center, Providence and Howard University hospitals joined later.

The linchpin of the alliance is Greater Southeast Community Hospital, which receives about two-thirds of the approximately $500 million the D.C. government pays to the alliance under a five-year contract, city officials said.

The Washington Times reported last month that executives at Doctors Community, which owns Greater Southeast, were spending hundreds of thousands of dollars for lobbying and campaign contributions to influence D.C. politics, even while inspectors found staffing shortages that jeopardized patient care.

Greater Southeast, the only hospital east of the Anacostia River, filed for bankruptcy last year, and now operates under a provisional license after city health inspectors found deficiencies in fire safety, staffing and anesthesia care.

City health inspectors will decide Oct. 12 whether to restore the hospital’s license or shut it down.

Greater Southeast also lost its accreditation last month after receiving failing grades from inspectors with the Joint Commission on Accreditation of Healthcare Organizations.

The result of those problems, Mr. McLean said, is that over the past two years patients have lost faith in Greater Southeast and increasingly turned to other hospitals, which have become overcrowded and financially strained.

After treating patients, these hospitals also had a difficult time getting reimbursed on time through the alliance, if they were reimbursed at all, he said.

“There is a problem here,” Mr. McLean said. “It’s like the 12-step recovery. The first step is admitting there’s a problem, but the city won’t even do that.”

Mr. McLean said alliance hospitals have been negotiating with city officials for increased reimbursement rates and faster payments for about a year.

He said the hospitals may consider leaving after the current contract runs out Tuesday. “We’ve heard rumors of a 30-day extension, but we haven’t heard anything from the city,” he said.

City officials said there is no Sept. 30 deadline.

“At any point in time, the contract can be renegotiated or renewed,” said Tony Bullock, spokesman for Mr. Williams.

“Neither side benefits by walking away. I think the hospitals do have some very valid issues, but we also have budget constraints.”

Mr. Bullock said city officials have not communicated recently with hospitals on negotiations because of Hurricane Isabel and because the District’s lead negotiator, John Koskinen, recently resigned as city administrator.

“We’re going to work things out,” Mr. Bullock said.

One stumbling block in negotiations, he said, is that taxpayer dollars are sometimes spent under the alliance’s “presumptive eligibility” policy to cover services provided to individuals who do not belong to the alliance.

But hospital officials say that burden increased dramatically when the District closed D.C. General and made financially shaky Greater Southeast the primary hospital for low-income residents.

“The general sentiment is that if the city steps up to the table, we can hang on for a while,” Mr. McLean said.

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