the Grace Report Provides Important Private Intelligence, Gathered Exclusively
for OBs & GYNs, Their Practice CEOs, and Key Administrators.

Headlines- November 1, 2004
THE GRACE REPORT

Headlines- November 1, 2004

Commentary and Opinion by Robert L. Michel:
First Alert For Two Major Ob-Gyn Market Changes

IF YOU ARE READING YOUR FIRST ISSUE OF THE GRACE REPORT, let me welcome you. Within the ob-gyn profession, you are first to learn about an unfolding market trend which will directly impact each of your adult female patients.You are also first in the profession to become aware of key developments in medical malpractice—and their expected impact on ob-gyns.

As a client and regular reader of the GRACE REPORT, you’ll find yourself
inside an exclusive circle. Let me explain by sharing a fascinating story with you. It starts back in 1991. That was the birth of what can be described as a SWAT team of critical thinkers in the business and management of healthcare. They had a single goal: to help physicians and their practice administrators sustain and improve the financial viability of their group practice.

Why this goal? Because it serves the needs of all physicians. A group practice must have sufficient revenue and operating margins to fund clinical services— and allow the group to acquire and deploy new healthcare technology.At the same time, a financially-viable group practice offers economic security to the physicians and their care team. That includes personal income, adequate retirement, and appropriate benefits.

During the past 13 years, this elite team has been first to identify key healthcare trends and alert physician clients to opportunities and liabilities. It played a key role in helping its physician clients stay ahead of all the destructive outcomes of managed care during the past decade. These physicians were winners throughout the 1990s—because they had accurate intelligence in advance and knew when to act.

You’d probably agree that the ob-gyn profession is beset with intractable
challenges, whether inadequate reimbursement, the skyrocketing cost of
malpractice insurance and legal expenses, or simply the attitude of many
payers against giving ob-gyns like you a fair shake. Until now, you and the
majority of your professional colleagues lacked a business and management resource that turned the tables in your favor.

The GRACE REPORT is here to be your answer.As a member of the GRACE REPORT Intelligence Group, you are plugged into the ob-gyn profession’s most powerful business resources. Our elite team of experts—with an established reputation for accurate intelligence and insightful business strategies—will regularly brief you about everything you need to know on the business and management of ob-gyn group practices. It’s a guarantee that you can keep your ob-gyn group in the first-rank of financial success and management execution.

Connecticut OBs “Win”Showdown Over Malpractice Surcharge

Per-pregnancy fee was to offset malpractice premium increases

CEO Summary: It was a risky business strategy that appears to have
paid off. To cope with rising malpractice insurance premiums, a
Connecticut-based partnership of ob-gyns was prepared to add a $500
surcharge on each pregnant woman's bill, effective September 1, 2004.
In an unexpected twist, private insurers, sympathetic to the problems
caused by skyrocketing malpractice premiums, have largely agreed to
increase various reimbursement rates enough to obviate the need for
the $500 per-pregnancy surcharge.

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“Laborist”: New Specialist Both Threat & Opportunity

Hospitals hiring laborist may begin impinging on traditional OB practices

CEO Summary: Changes in the makeup of the ob-gyn profession could
cause the emergence of a new practice model: an in-house ob-gyn dedicated solely to managing deliveries and handling obstetrical emergencies for larger hospitals. Advocates say the spread of this model could keep more young ob-gyns in practice and could benefit patients and hospitals. In Toledo, Ohio, one health system and a local ob-gyn medical group are taking the first steps to hire a laborist and evaluate this emerging new clinical practice model.

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Federal Govt. Leading March To Universal EMR

Ob-gyns should heed announcements: Feds want healthcare to go fully digital

CEO Summary: Earlier this year, President George W. Bush announced
a new goal for the nation: an electronic medical record (EMR) for every
patient within ten years. Last July, the GRACE REPORT predicted that the federal government would take the lead role in pushing healthcare to
adopt a universal electronic medical record. Ob-gyn group practices
will need to revise their information technology strategies to respond
to this development, which is closely-aligned to patient safety and payfor-
performance initiatives.

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Kaiser Permanent Revamps Cervical Cancer Screening

McKinsey & Co. executive generates national attention with strategic analysis

CEO Summary: Kaiser Permanente Northern California’s new guidelines for cervical cancer screening in Northern California call for combined Pap smear and HPV testing with longer intervals between screening. The HMO believes this will increase the quality of care for its patients while reducing costs down the road. Ob-gyns need to be aware of the clinical implications and the potential effects on their professional income as the rest of the medical community follows Kaiser’s lead. These new guidelines alter the annual exam protocol for adult women, so there will be a need for patient education.

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Managed Care UPDATE: Double-Digit Increase Predicted For HMO Premiums In 2005

Sixth consecutive year of HMO double-digit price rise will push employers and payers to squeeze docs

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INTELLIGENCE: Late & Latent

“CONTINUITY OF CARE” RECORD WILL PRECEDE EHR

NAVY NURSES IN THE BREACH AFTER CHARLEY

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