Word: bedford
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...Bedford is a torpid southern Indiana stone-quarry hamlet where the politics are dull, racial disputes are rare, and crime is so infrequent that Mayor John Williams boasts that his home has no lock on the front door. But bring up hospital loyalties--an allegiance some Bedford families have solemnly passed down for three generations--and townspeople are likely to get agitated. "You don't get the care you need there," 86-year-old Martha Terrell, a Dunn patient of 50 years' standing, says of the institution she won't patronize. "Whenever anyone new moves to town, I tell them...
There is broad agreement in Bedford that a merger would make sense. Services at the two hospitals overlap, and beds go empty. A study predicted that by 2001 Bedford will need only 65 beds, 95 fewer than it has now. "Those numbers are probably going to drive where we go with this whole thing," says John Birdzell, CEO of Bedford Regional. Dunn's CEO, Richard Hahn, does not disagree. "There's been a consensus that one hospital would be a good goal to strive for," he says. But over the past 15 years, four attempts to merge have failed when...
...hospital has lost a lot of money on many of my patients, but they've never told me about it," he says. Dunn contends it is more willing to refer patients to expensive specialists. Dr. Theresa Travis, a Dunn nephrologist who spends about 20% of her time at Bedford Regional, says she often sees patients with traditional insurance months ahead of HMO patients with similar conditions. "Managed-care patients are always referred very late," she says, in some cases making kidney failure more likely...
...result, health care is costlier at Dunn: the average charge for heart-failure and shock treatment is $7,892, for example, compared with Bedford Regional's $4,817. But Bedford Regional, which gets about a quarter of its revenue from managed care, vigorously disputes the notion that its treatment style is any less effective. "Just because you can stay twice as long at Dunn doesn't mean it's better health care," Birdzell says. He adds that Bedford Regional's drug-selection policies are not cost-driven. It prescribes both TPA and streptokinase, for instance, depending on the specifics...
...Bedford's strongest argument is that the whole nation is moving in its direction: critics say Dunn has been able to snub managed care only because Indiana has been among the states slowest to require it. Its economic good fortune will change, they say, when the two automobile companies with large plants in Bedford start requiring employees to shift to managed care and when Medicaid and Medicare begin pushing recipients into HMOs. At that point, if Dunn is to survive, it may have to sell out to a large for-profit chain. Should that happen, Bedford's medical civil...