Physicians Charge Medical Retainers For High Net Worth Families

In a story written by Brendan Doherty for The San Francisco Business Times, two doctors in Palo Alto are among a handful quietly operating "retainer" practices, into which they accept only a small number of patients. They offer a high level of personal attention, immediate access and an escape from health insurance bureaucracy. The retainer for a family can run up to $20,000 a year. Treatment is extra, and no insurance is accepted. Fed up with low payments and other insurance hassles, other doctors are looking to do the same. Among those known to be eying retainer practices are the Palo Alto Medical Foundation, Brown and Toland and Hill Physicians -- the region's three biggest physician groups -- plus physicians in Danville and Los Altos.

      Though retainer medicine is in its infancy in the Bay Area, it's already well established in other places like Seattle, where four-doctor medical practice MD2 has operated on a retainer basis for five years.

      "This is for people with a high net worth who want to be hand-carried through the medical system," said Duane Doberowitz, MD2's CEO.

      Doberowitz said his practice assigns 50 "family groups" to each of its four doctors. Each family group pays $20,000, plus incidental expenses. The agreement does not include costs related to catastrophes or consultation. In return, patients get a doctor who goes with them to specialists' consultations, answers his cell phone and makes house calls. MD2 is now looking at franchising its retainer model throughout the country at $75,000 a pop, and among those expressing interested was an unnamed group of docs in Danville. Back to TOC.

Ramsay Youth Services, Inc. Announces Second Quarter Results

Ramsay Youth Services, Inc. announced results for the second quarter ended June 30, 2001. The Company reported total revenues of $33,840,000 for the quarter, an increase of 34% over total revenues of $25,257,000 from the same period of the prior year. Net income for the second quarter increased to $796,000 or $0.08 per share, up from $107,000 or $0.01 per share for the same quarter in the prior year.

      For the six months ended June 30, 2001, the Company reported an increase of 35% in total revenues. Revenues reached $65,629,000 as compared to $48,714,000 for the same period in the prior year. Net income for the six months ended June 30, 2001 totaled $1,180,000 or $0.13 per share as compared to $267,000 or $0.03 in the same period of the prior year.

      Ramsay Youth Services, Inc. is a provider and manager of specialized treatment programs and services in nine states and the Commonwealth of Puerto Rico. The Company is also an operator of treatment facilities including behavioral healthcare hospitals, residential treatment centers and other specialized juvenile facilities. Back to TOC.

Johns Hopkins University Back in Fold

The U.S. government has allowed Johns Hopkins University to resume federally funded medical research on people after the prestigious Baltimore school promised to improve the protection of human subjects in its experiments, officials said on Monday.

      The government imposed the suspension last Thursday, faulting the Johns Hopkins School of Medicine for failing to prevent the June 2 death of a healthy volunteer in an asthma experiment involving a drug that no longer was approved for use in people by the Food and Drug Administration (news - web sites) (FDA).

      The decision by the Office for Human Research Protections (OHRP), part of the U.S. Department of Health and Human Services (HHS), came after officials at Johns Hopkins pledged to make changes to ensure the safety of human subjects and better review medical experiments.

      HHS spokesman Bill Hall said the agency's action allows for the immediate reinstatement of all studies that pose "no more than a minimal risk" to people taking part and a small number of studies that involve a higher risk to volunteers, such as being given drugs, and already have been properly cleared under the Johns Hopkins review process.

      Studies that carry a minimal risk include "noninvasive" data gathering such as collecting samples of blood, urine or saliva, giving procedures such as magnetic resonance imaging (MRI) or ultrasound, and answering surveys or questionnaires, Hall said. All the other studies must be given a fresh review by the institution under the new guidelines aimed at ensuring the safety of human subjects before resuming, he added.

      They have got to re-review a lot of studies. I just don't know the number, but it's a lot. They've got to do it one by one. It's going to take a while. The pace is really going to be set by how quickly Hopkins can do this. I think it's safe to say it's going to take more than just a few weeks," Hall said.

      Johns Hopkins receives more research money from the National Institutes of Health (NIH) than any other institution. It won $301 million in NIH funds last year. The school is conducting about 2,400 medical studies with tens of thousands of human subjects.

      School officials initially called the government's suspension an "unwarranted, unnecessary, paralyzing and precipitous action." Back to TOC.

HCA Profits Climb 21 Percent

HCA Inc. said its second-quarter profits before unusual items rose a higher-than-expected 21 percent, driven by increased admissions and improved reimbursements from the government and health insurers.

      Before gains on sales of facilities and restructuring of operations and before investigation and settlement-related costs, earnings totaled $271 million, or 50 cents per share.

      Analysts had expected a profit of 45 cents to 47 cents a share, with an average estimate of 46 cents, according to research firm Thomson Financial/First Call. Net income was $263 million, or 48 cents a share, after the items, compared with a year-earlier loss of $272 million, or 49 cents a share.

      The second-quarter 2000 loss included an after-tax charge of $498 million to settle Medicare fraud claims. Excluding that charge, the Nashville, Tennessee, company earned $223 million or 40 cents per share.

      The company's second-quarter revenues rose 8 percent to $4.47 billion from $4.13 billion.Including facilities owned by joint ventures, HCA had 194 hospitals and 78 ambulatory surgery centers, down from 204 hospitals and 83 ambulatory surgery centers last year.

      Revenues from facilities open more than a year rose 10.6 percent during the second quarter from a year ago. The number of patients admitted at those facilities increased 4.2 percent. In the second quarter, HCA's salaries and benefits costs increased to $1.82 billion or 40.7 percent of total revenues from $1.65 billion or 39.8 percent a year-ago. Back to TOC.

Community Health Systems, Inc. Announces Approval of Its Credit Agreement

Community Health Systems, Inc. has announced the approval of an amendment to its 1999 Amended and Restated Credit Agreement. The Credit Agreement is syndicated with a group of lenders led by The Chase Manhattan Bank and co-agents, Bank of America and The Bank of Nova Scotia. This amendment extends the maturity of a $200 million revolving credit facility and $263.1 million in acquisition loan commitments from December 31, 2002, to January 2, 2004. The amendment also included several other covenant changes favorable to the Company. With approval of the amendment, CHS has not only extended the maturity but also increased the dollars available for acquisitions until January 2, 2004.

      Community Health Systems is an operator of general acute care hospitals in non-urbancommunities throughout the country. Through its subsidiaries, the company currently owns, leases, or operates 53 hospitals in 20 states. Its hospitals offer a broad range of inpatient medical and surgical services, outpatient treatment and skilled nursing care. Back to TOC.

Universal Health Services, Inc. Reports Second Quarter EPS Growth of 34%

UHS, Inc. has announced that its net income and earnings per share (diluted) were $32.4 million and $.51 for the three month period ended June 30, 2001, and $68.6 million and $1.08 for the six month period ended June 30, 2001, respectively.

      Net income and earnings per share (diluted) were $23.3 million and $.38 for the three month period ended June 30, 2000, and $51.9 million and $.84 for the six month period ended June 30, 2000, respectively. The earnings per share (diluted) for all periods presented have been adjusted to reflect the two for one stock split in the form of a 100% stock dividend which was paid on June 1, 2001.

      Revenues increased 37% to $718 million in the three month period and by 31% to $1.4 billion in the six month period ended June 30, 2001. At June 30, 2001, the Company's balance sheet debt, net of cash, was $640 million and its shareholders' equity was $782 million. The Company reduced its net debt outstanding by $48 million during the quarter.

      Patient admissions to the Company's hospitals continued to grow during the quarter. For facilities owned in both the three month periods ended June 30, 2001 and June 30, 2000 admissions to the Company's acute care hospitals increased 6.3%, including a contribution of 1.7% from the McAllen Heart Hospital, while admissions to the Company's behavioral health facilities owned in both periods increased 6.0%.

      The Company's hospitals also benefited from favorable pricing trends in the quarter ended June 30, 2001. Revenue per admission grew 11% for the Company's acute care hospitals and 3% for the Company's behavioral health hospitals. Consolidated operating margins declined due to increases in operating expenses at the Company's acute care hospitals. Universal Health Services, Inc. is one of the nation's largest hospital companies, operating in 22 states, Washington, D.C., Puerto Rico and France. Back to TOC.

In This Issue--Also See Archive

Retainers for Patients with Healthy Net Worth?

In a story written by Brendan Doherty for The San Francisco Business Times, two doctors in Palo Alto...

Ramsay Announces Q2 Results

Ramsay Youth Services, Inc. announced results for the second quarter ended June 30, 2001. The Company report...

Johns Hopkins Regains Federal Funding

The U.S. government has allowed Johns Hopkins University to resume federally funded medical research ...

HCA Profits Soar

HCA Inc. said its second-quarter profits before unusual items rose a higher-than-expected 21 percent, dri...

Cash Transfusion for CHS

Community Health Systems, Inc. has announced the approval of an amendment to its 1999 Amended...

HMA Q3 Income Tops Chart

Health Management Associates, Inc. announced that net income for the quarter ended June 30, 2001 increased 24%...

LifePoint Doubles EPS

For the quarter ended June 30, 2001, net revenues were $151.6 million, up 13.8% from $133.3...

UHS Posts Strong Earnings

UHS, Inc. has announced that its net income and earnings per share (diluted) were $32.4 million and $.51 for

HMA Reports Record Third Q Net Income Growth of 24%

Health Management Associates, Inc. announced that net income for the quarter ended June 30, 2001 increased 24% to $54.1 million, up from $43.8 million for the same quarter a year ago. Earnings per share (diluted) for the quarter were $.21 per share, up from $.18 per share, on a 7.5% increase in diluted shares outstanding.

      Net patient service revenue grew a solid 21% to $473.2 million for the quarter ended June 30, 2001, up $82.1 million from $391.1 million for the same period a year ago. Net patient service revenue at hospitals owned and operated by HMA for one year or more was up 9.5%.

      This quarter represents the 51st consecutive quarter of same hospital revenue growth. Among the factors contributing to the growth were a strong 6.7% increase in admissions and a 4.8% increase in surgeries. Same store hospital EBITDA margins increased 30 basis points to 27.0% from 26.7% for the same period a year ago.

      Continued investment in emergency room services, including our innovative Nurse First and ProMed programs, contributed to a 6.9% growth in same hospital emergency room visits, compared to the same quarter last year. For the nine months ended June 30, 2001, net earnings, before non-cash, non-recurring charges, increased to $153.4 million compared to $128.6 million for the same period a year ago, or 19.3%.

      Diluted per share earnings for the period, before non-cash, non-recurring charges, were $.60 on 264.0 million shares as compared to $.53 on 244.9 million shares outstanding a year ago. The Company reported total net patient service revenue for the period of $1,388.6 million, an increase of 19% from $1,169.8 million in the comparable nine-month period. Accounts receivable management was, once again, excellent for the quarter.

      Days Sales Outstanding (DSOs) saw continued progress for the quarter, decreasing 1.2 days sequentially and a significant 8.9 days year over year to 72.2 days outstanding. Cash flow from operations increased an impressive $80.1 million compared to the nine month period a year ago, reflecting our continued emphasis on cash collections.

      Enhancing the Company's growth opportunities, during the quarter, the Company completed the acquisition of the 200-bed Carlisle Hospital in Carlisle, Pennsylvania. This sole community provider currently generates $60 million in net revenues. "HMA's reputation for delivering high quality healthcare and successfully completing five replacement hospitals made the difference.

      Carlisle's leaders sought to place their community's healthcare in the best possible hands, an industry leader, and HMA earned their confidence," added Mr. Vumbacco. "We are progressing in our efforts to complete the acquisition of the previously announced 80-bed sole community provider, Lee County Community Hospital in Pennington Gap, Virginia, and we are very excited about the other acquisition opportunities we are reviewing."

      The Company continues to enhance same store hospital growth through the investment of capital in medical services. Riverview Regional Medical Center in Gadsden, Alabama, honored as the state's top cardiac hospital, opened a new, state-of-the-art women's center during the quarter. With over 14,100 square feet of space, the center contains eight Labor/Delivery/Recovery/Post Partum Rooms (LDRPs) and one additional operating room. Births at the hospital have more than tripled in the month since the opening compared to the month before the addition.

      Other growth oriented capital expenditures that were completed during the quarter included three fixed-based magnetic resonance imaging units (MRI) in Statesboro, Georgia, Hartsville, South Carolina, and Haines City, Florida. Additional capital dollars were invested in a new cardiac catheterization lab in Haines City and a 10,000 square foot operating room addition in Marathon, Florida. These capital expenditures represent only a few of the ongoing projects undertaken by HMA to increase the level of quality healthcare and provide more services to the growing communities we serve.

      HMA is a large, non-urban hospital operator of general acute care hospitals in communities situated primarily in the Southeast and Southwest. The Company, after completing the previously announced transaction to acquire the 80-bed Lee County Community Hospital, will operate 38 facilities in 12 states with 5,304 licensed beds. HMA has experienced 12 years of uninterrupted operating earnings growth. Back to TOC.

LifePoint Hospitals Reports 100% Increase in Second Q EPS Before Extraordinary Item

For the quarter ended June 30, 2001, net revenues were $151.6 million, up 13.8% from $133.3 million a year ago. Income before extraordinary item for the quarter totaled $8.5 million, or $0.22 per diluted share, versus $3.7 million, or $0.11 per diluted share, in the prior-year period, representing increases of 130.3% and 100.0%, respectively.

      Shares used in calculating diluted earnings per share for the second quarter of 2001 included 3.7 million additional shares compared with the second quarter of 2000, primarily as a result of the secondary offering of common stock completed in March 2001.

      Including the extraordinary item, net income for the quarter ended June 30, 2001, totaled $6.9 million, or $0.18 per diluted share. Earnings before interest, income taxes, depreciation, amortization, ESOP expense, minority interest and extraordinary loss (EBITDA) increased 29.3% to $31.8 million from $24.6 million in the same period last year.

      For the six months ended June 30, 2001, net revenues were $305.9 million, up 13.6% from $269.3 million a year ago. Income before extraordinary item and gain on previously impaired asset for the six-month period totaled $17.1 million, or $0.46 per diluted share, versus $7.7 million, or $0.24 per diluted share, in the prior-year period, representing increases of 121.9% and 91.7%, respectively.

      Including the extraordinary item and gain on previously impaired asset, net income for the six months ended June 30, 2001, totaled $15.5 million, or $0.43 per diluted share. Earnings before interest, income taxes, depreciation, amortization, ESOP expense, minority interest, gain on previously impaired asset and extraordinary loss (EBITDA) increased 34.0% to $65.8 million from $49.1 million in the same period last year.

      In June, the Company announced that it had completed a $200 million, five-year amended and restated credit agreement with a syndicate of banks led by Fleet National Bank. The agreement increased the Company's available credit under its revolving credit agreement from $65 million to $200 million and extended the current agreement to five years. During the quarter, the Company wrote off $2.6 million of deferred loan costs related to the original credit agreement, which resulted in an extraordinary charge of $1.6 million, or $0.04 per diluted share.

      LifePoint Hospitals, Inc. operates 21 hospitals in non-urban areas. In most cases, the LifePoint facility is the only hospital in its community. LifePoint's non-urban operating strategy offers continued operational improvement by focusing on its five core values: delivering high quality patient care, supporting physicians, creating excellent workplaces for its employees, providing community value, and ensuring fiscal responsibility. Headquartered in Brentwood, Tennessee, LifePoint Hospitals is affiliated with over 6,000 employees. Back to TOC.

Diffenbaugh & Associates, Inc. is a physician consulting firm specializing in the recruitment and placement of psychiatrists throughout the United States. Diffenbaugh & Associates, Inc. recruits psychiatrists, period. All day, every day of the year we recruit physicians for our clients' organizations throughout the United States. We serve the needs of group practices, single and multi-system hospitals, specialty hospitals and community-based programs in 49 states. Over the years we have recruited and placed hundreds of physicians for our clients. We attribute our success to: Our experience, our values and our methods. Visit with one of our 6 full time associates to learn more about these opportunities.