x od Page 18 Ralph S. Smith, Dallas, ‘president, Blue Cross of Nor- theastern Pennsylvania, and Ben Badman Jr., Forty Fort, president of Wilkes-Barre’s Wyoming Valley Hospital, have jointly announced that results of an experimental, prospective reimbursement method- for the payment of hospital services on a ‘per case’ basis - indicate “that the unique approach has produced substantial savings and, conceivably, could become a significant factor in helping to stabilize rising hospital costs”. The joint announcement stated that an evaluation of the project which began Jan. 1, 1972 to date, based on a pre- determined payment for hospital inpatient care, regardless of the diagnosis, length of stay, or the services performed, confirms earlier hopes that the approach would prove useful in the search for reasonable health care savings’’. We're pleased about the theory’s practical, workable features’’, the participating parties said, ‘‘and although the amount of cases were small in number, the results of the study are impressive enough to warrant continuation of the experiment’’. Responsibility for designing the = mechanics of the Prospective = Reimbursement Blue Cross of Northeastern Pennsylvania in July, 1971, when, with the approval of the State Insurance Commissioner, it sought to develop a revised cost reimbursement coneept for making payments to hospitals, as a step toward helping to halt the spread of rising hospital cooperation of Wyoming Valley Hospital, an agreement to embark on the experiment was worked out. Blue Cross and Wyoming Valley Hospital agreed on a predetermined rate of payment that would apply for each case for care provided to Blue Cross subscribers. The one flat amount to be paid for each hospital case applied, regar- dless of the diagnosis, length of stay, or the services performed. - Determination of the prospective rate of payment, however, was not binding until an advance study of Wyoming Valley Hospital’s current budget and costs profile was made to insure that a fair, equitable reimbursement would be possible, even in the face of inflation and other unforeseen factors which could affect hospital costs during the ex- perimental period. Since the pre-determined rate of payment was not subject to adjustment during the period involved, Wyoming Valley Hospital faced the prospect of either a gain or loss. Under such an arrangement, with the cost per day and the length of stay in the hospital looming as the experiment’s two major fac- tors, there existed also on the part of the hospital the incentive to achieve prudent utilization control. Simply, it meant that hospital income would be adequate if the length of stay were justifiably reduced -- within the limits of reasonableness and medical necessity -- to allow for ad- mitting more cases and in- creasing the productivity of the institution. In this instance, cared for, due to a reduction in length of stay, the resultant savings then are shared by the hospital and Blue Cross. Con- versely, if the number of cases handled by the hospital are fewer because the average length of stay exceeds normal limits, this also becomes the hospital’s loss because of lower productivity. Blue Cross president Ralph S. Smith stated that ‘‘results of the experiment’s first six-month périod show that, of a projected 685 Blue Cross cases anticipated by the hospital, each of which was prospectively rated at $555, the actual number of cases cared for by the institution increased to 736, but the cost of each had dipped to $513 to show a hospital per case gain of $42. the average length of stay being shortened by slightly more than one day. On an overall basis, a reduction of 359 patient days was realized. Continuing ob- servation indicates that the good results obtained in the first six months are continuing’. In a companion effort to test costs of physicians’ services, Pennsylvania Blue Shield simultaneously inaugurated its own payment-by-diagnosis experiment which, much like the Blue Cross principle, agreed to pay participating physicians for inpatient medical care on a per-diagnosis basis with reimbursement based on the patient’s diagnosis rather than on the specific number and types of medical services provided by the physician. According to Pennsylvania Blue Shield President Robert E. Rinehimer, ‘‘The theoretical objective of the payment-by- diagnosis experiment marks a sound attempt towards achieving realistic savings in our health care delivery system. While more hospital beds will become available as a result of the reduced length of stay,. the physician, without being bound to existing fee schedules for certain services performed, also will be in the position to treat more cases while still receiving equitable payments for his services. We, of course, have been deeply interested in the experiment conducted by Blue Cross of Northeastern Pennsylvania and Wyoming Valley Hospital,” he added, ‘‘and particularly because of its positive approach toward stabilizing costs. Although the number of cases involved in our own experiment involving five physicians at Wyoming Valley Hospital was relatively small, we are con- tinuing to evaluate all aspects of the results. However small these results seem to be at the present time, they are never- theless encouraging enough to give cause for wider, more thorough testing, and this we are pledged to do.” Mr. Badman, whose hospital has been long identified with efforts to improve hospital performance, reported that the ‘per case approach’ on reimbursement had brought together all parties in the “hospital family” in a joint effort to become more NEWS TODAY! K rae A US Gal % out Sunday at the Lake. daily from 6 a.m. to midnight seven days a week. Local news and discussions and ‘a multi- music format of classical, show, jazz and blue grass music will be offered listeners. WVIA-FM also has joined National Public Radio, the only noncommercial national stations in 42 states, Puerto Rico and the District of Columbia. WVIA-FM will operate with 5,000 watts of power from the temporary tower location at months the tower will ‘be in- creased 300 feet in height. Mr. Strimel announced that Roy. Hoinowski, a Channel 44 staffer for five years, will serve as director of radio operations. Paul Evanosky, chief WVIA-TV engineer. John Sabo is pro- duction manager; George Graham, engineering, and Jean Zeller, traffic manager. WVIA-FM Radio will go on the air Monday morning, ac- cording to an anouncement by George H. Strimel Jr., station manager. WVIA-FM will be operated under the same management as WVIA-TV Channel 44, the region’s . public television station since 1966. The new FM stereo station at 89.9 on the dial will broadcast ILI PIL NLP 1t is likely that youngsters in the Lake-Lehman School District will have a supervised program of varied outdoor action taken by the district’s school board at its regular monthly meeting last Thursday night. According to plans’ outlined by high school principal An- the sum- mer program would: operate five half-days each week, beginning after July 4. As en- visioned by Mr. Marchakitus, the program would be primarily recreational in scope rather than a sports training session. Mr. Marchakitus suggested to the school directors that the program could logically be centered at the Lehman- Jackson school, Kenneth Williams and Ellis would prefer a more flexible program which would permit school district to participate in the activities. Their suggestion was taken under advisement. Mr. Marchakitus noted that the estimated cost of the program would be approxi- mately $1,000, and he reported that ‘‘the Lake-Lehman Boosters Club is extremely interested in this type of program and has allocated $200 for the purchase of supplies for the summer session. In other board action, senior class’ trip to Washington, D.C., May 16-18 was approved, with John Zaleskas, Francis Wilczewski, Stanley Gulbish, Maureen Purcell and Jeris Jordan appointed as chaperones. Approximately 90 students will participate in the trip. Two invitations extended to the Lake-Lehman High School Band were turned down by the directors because of scheduling difficulties; a third invitation was accepted. The band will Township Volunteer Fire Company’s parade May 26 at 6 pm. but will not perform in Wilkes-Barre’s Fine Arts Fiesta invitation refused by the direc- tors was from the Cherry Blossom Committee of West Pittston for the band’s presence May 12 at 6 p.m. Citing - “‘unresolved personal problems,” high school instruc- the board that she may have to retire during the 1973-74 school years. She asked that the board permit her to delay making a decision on the question until Jan. 1, 1974, noting that ‘‘your cooperation would be greatly appreciated.” Superintendent of schools Robert Z. Belles observed that Miss Thomas has served the school capably for many years, and the board agreed to honor Miss Thomas’s request. High school teacher Florence Finn requested and was granted amaternity leave for the 1973-74 school year. The school district’s: 145 kindergarten children will thrill to the antics of the Hamid- Morton Circus « clowns when Armory April 24 for a first-hand glimpse of the annual Shrine Circus. The trip will take the place of classes on that date; by the school district. The name of Jessica Morgan, stitute teacher list. The school hoard approved @ 7 8 for a new 54 passenger school will continue for a two week 0 cost of $2 per mechanic. Teeners League The Dallas and East Dallas Dallas Intermediate School field, Church Street. All ‘boys between the ages of 13 and 15 to report. Boys are reminded to bring their own gloves; THE FOLLOWING FISH : ALL FORMS OF MIMYOWS, SUCKERS AND. EELS MEASUR- ING LESS THAN 8 INCHES IN LENGTH, AND ALL FORMS OF DARTERS, KILLFISHES AND CHUBS MEASURING LESS TRAN 6 INCHES W LENGTH, AND STONE CATFISH OF WY SIZE). IT IS ILLEGAL 10 USE ANY OF SPECIES LARGER THAN THE MU SIZES GIVEN, UNLESS TARE BY HOOK AND LINE. AND. IT 15 ALSO ILLEGAL TO USE ANY SPECIES OF CARP OR GOLDFISH. FOR INFORMATION ON THE IENTIFICATION OF BAIT-FISH. CONTACT YOUR WATERWAYS PATROLMAN OR WRITE — PENNA. FISH COMMISSION - PO.BOX 1673 HARRISBURG, PA ~I7120. ppm ss ——————— DEPT. TO 12 NO@N i =e ed TN TUES QR NODS OD nT on << O00 Ore WA th nL] Ss DN pds FH UR SN ee ETS Pr me OY, TS DD PN PC oo
Significant historical Pennsylvania newspapers