When is a Hospital Not an Employer? and Re-thinking How We Pay for services and technologies–changing the health care payment paradigm?

Are some hospitals not employers? 

An interesting case is on the horizon in Washington State.  The case is Larry Ockletree vs. Franciscan Health System. (#88218-5) and revolves around an employee who was dismissed after he had a stroke.  He asked to be reinstated and was denied.  He filed suit against  the Franciscan Health System under the Washington Law Against Disability (RCW 49.60.040 (11).

However, religious non-profit organizations are excluded as employers under that law.  The case will be heard in the Washington State Supreme Court on May 9th.  Here is a link to the case itself.  I have had trouble opening up the link when I just copied and pasted it.  Go to the Supreme Court link below.  There is a search function in the upper right hand corner and you can type in Fransicans and disability and the link will take you straight to the case.  http://www.courts.wa.gov/appellate_trial_courts/supremecourt/

http://www.courts.wa.gov/content/Briefs/A08/882185%20plaintiff’s%20opening%20brief.pdf#search=franciscans and disability  (here is the link, you may be able to simply copy and paste).

Why is this an issue?  The largest health system in Seattle is now Swedish/Providence Health System.  Several other communities, such as Vancouver, Washington are concerned about services that are covered under state and/or federal law but conflict with Catholic values and are not covered in those institutions. Here are some interesting local stories from Seattle and Vancouver, WA.



Because insurance is regulated at the state level, I have no idea if other states or how many other states exclude religious, non-profit organizations from being considered employers.  Nor do we have any idea yet how the Washington State Supreme Court will decide.

Good news on Data, Costs and Outcomes

Hundreds of hospitals in a data-practice-sharing project have shown significant reductions in costs, mortality and infections.  The 333 some hospitals participation in Premier Healthcare Alliance’s project called Quest save 92,000 lives and $9.1 billion in the past 4.5 years compared with what would be expected for its hospitals. Alan R. Yordy, President and Chief Mission Officer, Peace Health, based in Bellevue, WA is on Premier’s Board of Directors.   Peace Health Operates the following hospitals in Alaska, Oregon and Washington:   Alaska PeaceHealth Ketchikan Medical Center;  Washington PeaceHealth St. John Medical Center, PeaceHealth St. Joseph Medical Center,  PeaceHealth Peace Island Medical CenterPeaceHealth Southwest Medical Center Oregon Cottage Grove Community Hospital, Peace Harbor Hospital, Sacred Heart Medical Center at RiverBendSacred Heart Medical Center University District

For the full story, read:   http://www.healthleadersmedia.com/content/QUA-290313/Berwick-Quest-Program-Results-A-Breakthrough

How We Pay for Health Care

These three articles grabbed my attention.  Not only are national groups calling to examine how we pay physicians, given the rapid changes in technology do we need to re-define how we organize and pay for services and new technologies?  Then, there is the intriguing article from www.xconomy.com about the tension between providing expensive state of the art technologies and amortizing the investment.

If improved technology means shorter hospital stays and less invasive procedures, what happens to cardio centers of excellent, which are some of the most profitable lines of business for hospitals?  And the doctors performing those procedures?




Spokane’s Spokesman Review Series on Re-inventing Health Care

The Spokesman Review just complete a week long series on the Affordable Care Act, its implications and challenges.  Well worth the read.


Kathleen O’Connor, (c) March 25, 2013







About Kathleen

Kathleen O’Connor: 30+ year health care consumer advocate, non-profit executive and author. For more information about Kathleen, please see "About" on the main content bar above.
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