Health Breakfast, October 10, 1985
Item
of 1
- Other Media
-
lead_389_004_all_tr.txt - Transcription (Scripto)
- Read Full Text Only (TXT)
- Extent (Dublin Core)
- 45 Pages
- File Name (Dublin Core)
- lead_389_004_all
- Title (Dublin Core)
- Health Breakfast, October 10, 1985
- Date (Dublin Core)
- 1985-10-10
- Date Created (Dublin Core)
- 1985-10-10
- Congress (Dublin Core)
- 99th (1985-1987)
- Topics (Dublin Core)
- See all items with this valueHealth services accessibility--Law and legislation
- See all items with this valueHealth insurance
- Policy Area (Curation)
- Health
- Creator (Dublin Core)
- Dole, Robert J., 1923-2021
- Record Type (Dublin Core)
- notes (documents)
- Rights (Dublin Core)
- http://rightsstatements.org/vocab/CNE/1.0/
- Language (Dublin Core)
- eng
- Collection Finding Aid (Dublin Core)
- https://dolearchivecollections.ku.edu/index.php?p=collections/findingaid&id=26&q=
- Physical Location (Dublin Core)
- Collection 007. Box 389, Folder 4
- Institution (Dublin Core)
- Robert J. Dole Institute of Politics, University of Kansas, Lawrence, KS
- Archival Collection (Dublin Core)
- Robert J. Dole Republican Leadership Collection, 1985-1996
- Full Text (Extract Text)
-
HEALTH BREAKFAST ATTENDEES
Thursday, October 10, 8:00 a.m., Room S-230
(Coffee and Breakfast in S-207)
Senator Dole
Senator Hatch (check mark)
Senator Heinz
Senator Wilson (check mark)
Senator Quayle
Sheila Burke
Dr. James H. Sammons (check mark)
Executive Vice President
American Medical Association
535 N. Dearborn
Chicago, Illinois 60610
(312) 645-4302
Virgil S. Edwards (check mark, *)
Administrator
Redbud Community Hospital
Redbud Hospital District
Clearlake, California
(707) 994-6486
Eunice Cole, President (check mark, *)
American Nurses Association
2420 Pershing Road
Kansas City, Missouri 64108
(816) 474-5720
Jerome A. Crest, President and Administrator (check mark, *)
Emanuel St. Joseph's Hospital
325 Garden Boulevard
Mankato, Minnesota 56001
James A. Vohs (check mark, *)
Chairman, President and Chief Executive Officer
Kaiser Foundation Health Plan
The Ordway Building
One Kaiser Plaza
Oakland, California 94612
(415) 271-5910
Dr. William S. Hotchkiss (check mark)
Chairman, Board of Trustees
American Medical Association
2147 Old Greenbriar Road
Chesapeake, Virginia 23320
Samuel H. Howard (check mark, *)
Senior Vice President-Public Affairs
Hospital Corporation of America
1 Park Plaza
Nashville, Tennessee 37202
(615) 327-9551
Judith Ryan, Executive Director (check mark, *)
American Nurses Association
2420 Pershing Road
Kansas City, Missouri 64108
(816) 474-5720
Dr. Robert Heyssel (check mark, *)
President
Johns Hopkins Hospital
600 North Wolfe
Baltimore, Maryland 21205
(301) 955-5667
entire page handwritten:
Vohs
Arg's sk-
need some chqs-
keep eye on himo-
risk contracts-
keep out bad guys-
quality concerns-
-costs are (illegible)
under control-
quality now the issue-
-movement of pts into
medicare risk
contracts - problem
fw Kaiser -
heyssel
we are not looking for federal govt
to bail us out-
need to give (illegible)-
-people falling
thru the cracks-
BOB DOLE
KANSAS
UNITED STATES SENATE
OFFICE OF THE MAJORITY LEADER
WASHINGTON, DC 20510
October 9, 1985
MEMORANDUM
TO: SENATOR DOLE
FROM: SHEILA BURKE
SUBJECT: HEALTH BREAKFAST
Attached is a list of confirmed attendees for tomorrow morning's scheduled breakfast.
For this first health breakfast, I included representation from the key hospital groups, the American Hospital Association, the Federation of American Hospitals, the Public Hospital Association, and the Council of Teaching Hospitals.
In addition, the two largest individual provider groups will be represented, the American Medical Association and the American Nurses Association.
The hospital representatives that will be present represent a spectrum of institutions from very small to very large, both teaching and non-teaching and proprietary and non-profit or public.
The Kaiser Health Maintenance Organization, which was also invited, is the largest HMO in the country and unlike many other HMOs, actually owns a number of hospitals in addition to operating HMOs throughout the country.
The groups have been told that the purpose of the discussion is to review current problems that have resulted from recent changes in our payment systems for the Federal health programs. Also of interest are the questions being raised about the quality of care being provided and access and sources of payments for services provided to the indigent.
Atts.
(entire page handwritten)
uncompensated - care -- howard
f impact
caid threshold
risk poor sm business
grants to specific hospitals to care for indigent
short term unemployed continuity
howard
caps = (down arrow) quality 86
(illegible) = access 87
-rural good example
-caid caps
Edwards
sm rurals
don't need all -
but some recc.-
--> tax exempt
finance
for non profit hop's -
- need access
HEALTH BREAKFAST ATTENDEES
Thursday, October 10, 8:00 a.m., Room S-230
(Coffee and Breakfast in S-207)
Dr. James H. Sammons
Executive Vice President
American Medical Association, Chicago, Illinois
- Chief Executive Officer for 10 1/2 years.
- Previously practiced family medicine in Texas for approximately 20 years.
Dr. William S. Hotchkiss
Chairman, Board of Trustees
American Medical Association, Chesapeake, Virginia
- Presently a thoracic surgeon in Chesapeake, Virginia.
- Currently a member of the attending staffs of the Leigh Memorial Hospital and Chesapeake General Hospital in Norfolk.
- Previously AMA Commissioner to the Joint Commission on the Accreditation of Hospitals before election to the Board of Trustees in 1978.
Virgil S. Edwards
Administrator
Redbud Community Hospital, Clearlake, CA
- Represents Public Hospital Association.
- Has been in the health care field for about 9 years.
- Before becoming Administrator of Redbud Community Hospital in 1984, was assistant administrator of a 398 bed hospital.
- Redbud, a 27 bed hospital located in a rural community, provides primarily medical surgical services.
- The hospital was involved in a major dispute with HHS last winter over the implementation of the DRG system and their payment levels. Part of their concerns involved the payment for services provided to the indigent.
(entire page handwritten)
- physicians refusing
to take chronic pt's-
- on theirs - they are losing millions
- 3rd yr of drq's will be the worst -->
--> drqs not reflective of real market
- the one restraint on drq's = will be malpractice -- not pro's -
Sammons
8.5M employed in health delivery system -
risk in (up arrow) unemployment -
particularly re: nurses = (down arrow) quality of care
Edwards
small rural hospitals (illegible) problems
large (illegible) of medicare/caid - drq's built on coverages
Crest
contact made i hospitals i drqs
tax exempt bonds - they need access so they can
brag about changes needed in institutions
to (up arrow) amb. services -
pt's leaving sicker/quicker -
- making arrangements to allow pt's to stay in empty
beds and pay themselves -
- may lose drq's/medicare because of this -
Samuel H. Howard
Senior Vice President - Public Affairs
Hospital Corporation of America, Nashville, Tennessee
- Represents Federation of American Hospitals.
- Served as White House Fellow to Arthur Goldberg from 1966-1967.
- Served as a member of the 1982 Advisory Council on Social Security which studied medicare program.
- An employee of Hospital Affiliate when it was acquired by Hospital Corporation of America in 1981. Was then named Senior Vice President - Public Affairs.
- HCA, a proprietary company, owns and operates 176 hospitals in the US with a total of about 29,000 beds. In addition, they manage another 190 hospitals, with 24,000 beds. They are currently located throughout the country and are present in about 35-40 states.
Eunice Cole
President
American Nurses Association, Kansas City
- Currently serving her second term as President of the American Nurses Association.
- From 1974-1976 was President of the Washington State Nurses Association.
Dr. Judith Ryan
Executive Director
American Nurses Association, Kansas City
- From 1976-1980 Dr. Ryan served as Director of Nursing Education at the Rochester Methodist Hospital in Rochester, Minnesota.
- Dr. Ryan has been with the American Nurses Association since 1980 and has been executive director since 1982.
(entire page handwritten)
2
SNF/HH taking care of sicker pt's - increased demand for nsg.
<--> services in these settings
Sammons
Hopkins/AMA (illegible) quality study
Heyssel
house/stall - under increasing pressure - frozen levels of pay -
fewer admissions
intra system changing - greater pressures (down arrow) quality
Sammons
don't force reductions in (illegible)/financing too soon -
we need quality residents
Ryan
demand for home care in community -
doing study on acuity - (up arrow) demand for nsg
services and patient population shifts -
concerns: VNA etc. being challenged by (illegible) service home health agencies -
no coordination of care -
Cole
people falling through the cracks - particularly frail
elderly -
need to look at under(illegible) traditional agencies
Vohs
competition getting wild out there - surons quality concerns -
uncompensated care becomes greater concern because
of competition
Howard
25% fewer pt's - mostly reductions in private patients -
but now also have time for medicare
Los stable now after dropping
have laid off 6,500 personnel
- bad debts 2-3% higher
- rural hosp's - not likely to survive because of drq's
-3-
Jerome A. Crest
President and Administrator
Emanuel St. Joseph's Hospital, Mankato, Minnesota
- Represents American Hospital Association.
- Has been President and Administrator of Emanuel St. Joseph's Hospital since 1984.
- Recently completed 18 months service as chairman of the Minnesota Hospital Association.
- Emanuel St. Joseph's is a 260 bed hospital which provides a broad range of services.
Dr. Robert Heyssel
President
Johns Hopkins Hospital, Baltimore, Maryland
- Represents American Association of Medical Colleges, Council of Teaching Hospitals
- Named President in July 1983 after serving as Executive Vice President and Director since 1972.
- Is professor of Medicine at Johns Hopkins School of Medicine.
- Headed an Institute of Medicine Committee on controlling the supply of beds and a National Academy of Sicnes Committee regarding emergency medical services.
- Hopkins is a very large, 1069 bed, major teaching facility providing a broad range of services.
James A. Vohs
Chairman, President and CEO
Kaiser Foundation Health Plan
- Mr. Vohs has been with the Kaiser Foundation Health Plan since 1952.
- Kaiser has approximately 4.7 million enrollees nationwide. The organization is organized into 12 regions and is present in 15 states.
- Kaiser recently purchased an HMO in Kansas City which is affiliated with the University of Kansas Medical Center. They currently have about 9,300 enrollees.
(entire page handwritten)
hurig
(illegible)
recon
waiver
no fee freeze
Quayle
GME
FMG's -
maldrotib. of (illegible)'s primary care
Wilson
nsg. homes/qual.
pps - quality/aged
quality of care in military
concurrent/prospective quality ck - not retrospective
Hotchkiss
fee freeze/congress
breaking contract
don't like pal/non-pal - old mix
hatch/md's claiming they will request pt's
Hotchkiss - not wide spread - competition growing
Sammons
not widespread - but real concern re: access/accountability
drq's - counterproductive re: liability/quality - (up arrow) malpractice - cosponsor hatch
Hatch
malpractice = too much care as protection
Hurig
drq's create opportunity for malpractice
Sammons
we're sending them home sicker/quicker
Heyssel
- old don't like being sent home from ambulatory surgery - need to
loosen up on amb surg rules
- drq's don't measure what they are supposed to --
- people fall out of averages -
higher costs of teaching hospitals
14% educational costs
Ryan
impact on nsg - drq's don't look @ nsg resource use -
shorter length of stay reduces ability to
prepare pt's for home
HEALTH BREAKFAST ATTENDEES
Thursday, October 10, 8:00 a.m., Room S-230
(Coffee and Breakfast in S-207)
Dr. James H. Sammons
Executive Vice President
American Medical Association, Chicago, Illinois
- Chief Executive Officer for 10 1/2 years.
- Previously practiced family medicine in Texas for approximately 20 years.
Dr. William S. Hotchkiss
Chairman, Board of Trustees
American Medical Association, Chesapeake, Virginia
- Presently a thoracic surgeon in Chesapeake, Virginia.
- Currently a member of the attending staffs of the Leigh Memorial Hospital and Chesapeake General Hospital in Norfolk.
- Previously AMA Commissioner to the Joint Commission on the Accreditation of Hospitals before election to the Board of Trustees in 1978.
Virgil S. Edwards
Administrator
Redbud Community Hospital, Clearlake, CA
- Represents Public Hospital Association.
- Has been in the health care field for about 9 years.
- Before becoming Administrator of Redbud Community Hospital in 1984, was assistant administrator of a 398 bed hospital.
- Redbud, a 27 bed hospital located in a rural community, provides primarily medical surgical services.
- The hospital was involved in a major dispute with HHS last winter over the implementation of the DRG system and their payment levels. Part of their concerns involved the payment for services provided to the indigent.
-2-
Samuel H. Howard
Senior Vice President - Public Affairs
Hospital Corporation of America, Nashville, Tennessee
- Represents Federation of American Hospitals.
- Served as White House Fellow to Arthur Goldberg from 1966-1967.
- Served as a member of the 1982 Advisory Council on Social Security which studied medicare program.
- An employee of Hospital Affiliate when it was acquired by Hospital Corporation of America in 1981. Was then named Senior Vice President - Public Affairs.
- HCA, a proprietary company, owns and operates 176 hospitals in the US with a total of about 29,000 beds. In addition, they manage another 190 hospitals, with 24,000 beds. They are currently located throughout the country and are present in about 35-40 states.
Eunice Cole
President
American Nurses Association, Kansas City
- Currently serving her second term as President of the American Nurses Association.
- From 1974-1976 was President of the Washington State Nurses Association.
Dr. Judith Ryan
Executive Director
American Nurses Association, Kansas City
- From 1976-1980 Dr. Ryan served as Director of Nursing Education at the Rochester Methodist Hospital in Rochester, Minnesota.
- Dr. Ryan has been with the American Nurses Association since 1980 and has been executive director since 1982.
-3-
Jerome A. Crest
President and Administrator
Emanuel St. Joseph's Hospital, Mankato, Minnesota
- Represents American Hospital Association.
- Has been President and Administrator of Emanuel St. Joseph's Hospital since 1984.
- Recently completed 18 months service as chairman of the Minnesota Hospital Association.
- Emanuel St. Joseph's is a 260 bed hospital which provides a broad range of services.
Dr. Robert Heyssel
President
Johns Hopkins Hospital, Baltimore, Maryland
- Represents American Association of Medical Colleges, Council of Teaching Hospitals
- Named President in July 1983 after serving as Executive Vice President and Director since 1972.
- Is professor of Medicine at Johns Hopkins School of Medicine.
- Headed an Institute of Medicine Committee on controlling the supply of beds and a National Academy of Sicnes Committee regarding emergency medical services.
- Hopkins is a very large, 1069 bed, major teaching facility providing a broad range of services.
James A. Vohs
Chairman, President and CEO
Kaiser Foundation Health Plan
- Mr. Vohs has been with the Kaiser Foundation Health Plan since 1952.
- Kaiser has approximately 4.7 million enrollees nationwide. The organization is organized into 12 regions and is present in 15 states.
- Kaiser recently purchased an HMO in Kansas City which is affiliated with the University of Kansas Medical Center. They currently have about 9,300 enrollees.
UNITED STATES SENATE
OFFICE OF THE MAJORITY LEADER
WASHINGTON, DC
BOB DOLE
KANSAS
October 15, 1985
Dear Mrs. Cole:
Thank you for attending last Thursday's breakfast meeting here in Washington. I am sorry that I was delayed but enjoyed the opportunity to meet with you following your discussion with Senators Heinz, Quayle, Wilson, and Hatch.
I particularly appreciated your comments on the need to undergird our traditional home health agencies. These services have become increasingly important as we create incentives for beneficiaries to be discharged earlier, or simply remain at home, for the majority of their care.
Clearly also of concern is the care of those who "fall through the cracks" of traditional financing mechanisms. We will continue to seek out ways to care for these individuals without further adding to our deficit problems.
I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance.
Sincerely yours,
(signature)
Bob Dole
Mrs. Eunice Cole
President
American Nurses Association
2420 Pershing Road
Kansas City, Missouri 64108
UNITED STATES SENATE
OFFICE OF THE MAJORITY LEADER
WASHINGTON, DC
BOB DOLE
KANSAS
October 15, 1985
Dear Dr. Hotchkiss:
Thank you for your willingness to attend the breakfast meeting last week. I am sorry I was delayed and unable to join you but understand that the discussion was very useful.
I know you are particularly concerned with the continuation of the fee freeze and the participating physician program. Unfortunately, our continued battle to reduce the Federal deficit has again forced us to make a number of very difficult decisions. I can understand your frustration with what appears to be the breaking of an agreement with respect to the freeze, but you must also understand our dilemma with a projected deficit in excess of $170 billion.
Over the long term, I agree that together we must begin to seriously examine payment reform. We have a responsibility to both the medicare beneficiary and to the physicians nationwide who care for these patients, to
-2-
create a reasonable and equitable payment system.
I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance.
Sincerely yours,
(signature)
BOB DOLE
Majority Leader
Dr. William S. Hotchkiss
Chairman, Board of Trustees
American Medical Association
2147 Old Greenbriar Road
Chesapeake, Virginia 23320
UNITED STATES SENATE
OFFICE OF THE MAJORITY LEADER
WASHINGTON, DC
BOB DOLE
KANSAS
October 15, 1985
Dear Dr. Ryan:
Thank you for attending last Thursday's breakfast meeting here in Washington. I am sorry that I was delayed but enjoyed the opportunity to meet with you following your discussion with Senators Heinz, Quayle, Wilson, and Hatch.
I was particularly interested to learn of your ongoing survey of home health agencies and your intention of learning more about the acuity of the patient mix and the resulting nursing service needs. It has been clear to me for some time, particularly since the implementation of the Prospective Payment System, that attention needed to be given to both home health care service providers and nursing home service providers. It may well be time to reexamine the design and financing of these benefits. Patient care needs seemed to have changed as has our capacity to care for people in non-institutional settings. As we continue to urge reductions in the use
-2-
of inpatient services, we must make an effort to assure that quality, alternative services are readily available.
I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance.
Sincerely yours,
(signature)
BOB DOLE
Majority Leader
Dr. Judith Ryan
Executive Director
American Nurses Association
2420 Pershing Road
Kansas City, Missouri 64108
UNITED STATES SENATE
OFFICE OF THE MAJORITY LEADER
WASHINGTON, DC
BOB DOLE
KANSAS
October 15, 1985
Dear Jim:
Thank you for attending last Thursday's breakfast meeting here in Washington. I am sorry that I was delayed but enjoyed the opportunity to meet with you following your discussion with Senators Heinz, Quayle, Wilson, and Hatch.
I particularly appreciated your comments regarding the need to keep a close eye on the quality of the health care services provided to the elderly. As you point out, this is especially true with respect to certain prepaid health plans. We cannot afford a repeat of the problems documented in California in the 1970's.
Of course, on the non-HMO side, we must be equally as vigilant. The Prospective Payment System has achieved a great deal in bringing about reductions in cost and lengths of stay, but neither of these
-2-
achievements can overcome serious quality of care issues should they occur.
I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance.
Sincerely yours,
(signature)
BOB DOLE
Majority Leader
James A. Vohs
Chairman, President, and Chief Executive Officer
Kaiser Foundation Health Plan
The Ordway Building
One Kaiser Plaza
Oakland, California 94612
UNITED STATES SENATE
OFFICE OF THE MAJORITY LEADER
WASHINGTON, DC
BOB DOLE
KANSAS
October 15, 1985
Dear Mr. Edwards:
Thank you for attending last Thursday's breakfast meeting here in Washington. I am sorry that I was delayed but enjoyed the opportunity to meet with you following your discussion with Senators Heinz, Quayle, Wilson, and Hatch.
I particularly appreciated hearing your concerns about the survival of small rural hospitals and the need of certain institutions for continued access to tax exempt bonds.
With respect to rural hospitals, it was clear from the outset of the Prospective Payment System that we might well need to make adjustments. As you know, the Department was directed to prepare a study on the need to make adjustments for small rural hospitals; the results are not due for some months however. In the interim, I would be very interested in your thoughts on how best to isolate some of the legitimate needs of these institutions and address them.
With respect to tax exempt bonds, as I indicated in our discussion, it appears unlikely that the tax reform bill will see
-2-
action in the Senate this year. However, in anticipation of these discussions, I will review carefully the current use of this authority and its value to non-profit institutions like your own.
I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance.
Sincerely yours,
(signature)
BOB DOLE
Majority Leader
Virgil S. Edwards
Administrator
Redbud Community Hospital
Redbud Hospital District
Clearlake, California 95422
UNITED STATES SENATE
OFFICE OF THE MAJORITY LEADER
WASHINGTON, DC
BOB DOLE
KANSAS
October 15, 1985
Dear Mr. Crest:
Thank you for attending last Thursday's breakfast meeting here in Washington. I am sorry that I was delayed but enjoyed the opportunity to meet with you following your discussion with Senators Heinz, Quayle, Wilson, and Hatch.
I particularly appreciated hearing your concerns about the survival of small rural hospitals. It was clear from the outset of the Prospective Payment System that we might well need to make a limited number of adjustments to meet certain specific needs. To assist us, as you know, the Department was directed to prepare a study on the needs of small rural hospitals; the results are not due for some months however. In the interim, I would be very interested in your thoughts on how best to isolate some of the legitimate needs of these institutions and address them.
I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance.
Sincerely yours,
(signature)
BOB DOLE
Majority Leader
Jerome A. Crest
President and Administrator
Emanuel St. Joseph's Hospital
325 Garden Boulevard
Mankato, Minnesota 56001
UNITED STATES SENATE
OFFICE OF THE MAJORITY LEADER
WASHINGTON, DC
BOB DOLE
KANSAS
October 15, 1985
Dear Dr. Heyssel:
Thank you for attending last Thursday's breakfast meeting here in Washington. I am sorry that I was delayed but enjoyed the opportunity to meet with you following your discussion with Senators Heinz, Quayle, Wilson, and Hatch.
I particularly appreciated your comments on the need to find a method of financing care for those without access to any financial support. As I mentioned, considerable time was spent on a bill last year which dealt with the insurance needs of the unemployed. Though we were unable to secure passage at that time, we may be well served by a review of that initiative once again. However, as you pointed out, the problem is not simply a Federal issue, but rather one that needs the attention of all.
I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance.
Sincerely yours,
(signature)
BOB DOLE
Majority Leader
Dr. Robert Heyssel
President
Johns Hopkins Hospital
600 North Wolfe
Baltimore, Maryland 21205
UNITED STATES SENATE
OFFICE OF THE MAJORITY LEADER
WASHINGTON, DC
BOB DOLE
KANSAS
October 15, 1985
Dear Jim:
Thanks for taking the time to attend last week's breakfast meeting. Unfortunately, I was unavoidably delayed and missed getting the chance to talk with you, however, I understand the discussion went quite well.
Like you, I am concerned that as we continue to try to bring health care costs under control, we keep a close eye on the quality of care being provided to medicare beneficiaries nationwide. I urge you to let me know if you have any particular concerns that we should address at this time and look forward to seeing you in the near future.
Sincerely yours,
(signature)
BOB DOLE
Majority Leader
Dr. James H. Sammons
Executive Vice President
American Medical Association
535 N. Dearborn
Chicago, Illinois 60610
UNITED STATES SENATE
OFFICE OF THE MAJORITY LEADER
WASHINGTON, DC
BOB DOLE
KANSAS
October 15, 1985
Dear Sam:
Thank you for attending last Thursday's breakfast meeting here in Washington. I am sorry that I was delayed but enjoyed the opportunity to meet with you following your discussion with Senators Heinz, Quayle, Wilson, and Hatch.
I particularly appreciated your comments on the need to find a method of financing care for those without access to any financial support. As I mentioned, considerable time was spent on a bill last year which dealt with the insurance needs of the unemployed. Though we were unable to secure passage at that time, we may be well served by a review of that initiative once again. However, as you pointed out, the problem is not simply a Federal issue, but rather one that needs the attention of all.
I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance.
Sincerely yours,
(signature)
BOB DOLE
Majority Leader
Samuel H. Howard
Senior Vice President - Public Affairs
Hospital Corporation of America
1 Park Plaza
Nashville, Tennessee 37202
HEALTH BREAKFAST ATTENDEES
Thursday, October 10, 8:00 a.m., Room S-230 (handwritten: Hotchkiss)
(Coffee and Breakfast in S-207)
handwritten in top margins: Chall, (illegible), Dole, Vohs, Wils, Edward, Heinz, Cole, Hatch, Heyssel, Quayle
Senator Dole
Senator Hatch
Senator Heinz
Senator Wilson (check mark)
Senator Quayle (check mark)
Sheila Burke
Dr. James H. Sammons
Executive Vice President
American Medical Association
535 N. Dearborn
Chicago, Illinois 60610
(312) 645-4302
Virgil S. Edwards
Administrator
Redbud Community Hospital
Redbud Hospital District
Clearlake, California
(707) 994-6486
Eunice Cole, President
American Nurses Association
2420 Pershing Road
Kansas City, Missouri 64108
(816) 474-5720
Jerome A. Crest, President and Administrator
Emanuel St. Joseph's Hospital
325 Garden Boulevard
Mankato, Minnesota 56001
James A. Vohs
Chairman, President and Chief Executive Officer
Kaiser Foundation Health Plan
The Ordway Building
One Kaiser Plaza
Oakland, California 94612
(415) 271-5910
Dr. William S. Hotchkiss
Chairman, Board of Trustees
American Medical Association
2147 Old Greenbriar Road
Chesapeake, Virginia 23320
Samuel H. Howard
Senior Vice President - Public Affairs
Hospital Corporation of America
1 Park Plaza
Nashville, Tennessee 37202
(615) 327-9551
Judith Ryan, Executive Director
American Nurses Association
2420 Pershing Road
Kansas City, Missouri 64108
(816) 474-5720
Dr. Robert Heyssel
President
Johns Hopkins Hospital
600 North Wolfe
Baltimore, Maryland 21205
(301) 955-5667
only note on page (handwritten): Thursday; 3; dole
TENTATIVE
HEALTH BREAKFAST ATTENDEES
Thursday, October 10, 8:00 a.m., Room S-230
(Coffee and Breakfast in S-207)
handwritten at top of page: Packwood, Chafee
Senator Dole (handwritten: confirmed)
Senator Durenberger (handwritten: ?)
Senator Hatch (handwritten: Cindy - 135 Russell)
Senator Heinz (handwritten: confirmed)
Senator Chafee (crossed out)
Senator Wilson (handwritten: Dottie w/c/b)
Senator Quayle (handwritten: Cynthia w/c/b - SH - 524)
Sheila Burke (handwritten: confirmed)
Dr. James H. Sammons (handwritten: MD, confirmed)
Executive Vice President
American Medical Association
535 N. Dearborn
Chicago, Illinois 60610
(312) 645-4302
Virgil S. Edwards (handwritten: confirmed)
Administrator
Redbud Community Hospital
Redbud Hospital District
Clearlake, California
(707) 994-6486
Eunice Cole, President (handwritten: conf.)
American Nurses Association
2420 Pershing Road
Kansas City, Missouri 64108
(816) 474-5720
Jerome A. Crest, Administrator (handwritten: conf.)
Emanuel St. Joseph's Hospital
325 Garden Boulevard
Mankato, Minnesota 56001
James A. Vohs (handwritten: conf.)
Chairman, President and Chief Executive Officer
Kaiser Foundation Health Plan
The Ordway Building
One Kaiser Plaza
Oakland, California 94612
(415) 271-5910
handwritten note: 1:15-9:15 tonight, Sheraton Grand
William H. Hotchkiss, MD (handwritten: confirmed)
Chairman, Board of Trustees
American Medical Association
2147 Old Greenbriar Road
Chesapeake, Virginia 23320
Samuel H. Howard (handwritten: conf.)
Senior Vice President - Public Affairs
Hospital Corporation of America
1 Park Plaza
Nashville, Tennessee 37202
(615) 327-9551
Judith Ryan, Executive Director (handwritten: conf.)
American Nurses Association
2420 Pershing Road
Kansas City, Missouri 64108
(816) 474-5720
Dr. Robert Heyssel (handwritten: conf.)
President
Johns Hopkins Hospital
600 North Wolfe
Baltimore, Maryland 21205
(301) 955-5667
TENTATIVE (outlined)
HEALTH BREAKFAST ATTENDEES
Thursday, October 10, 8:00 a.m., Room S-230
Senator Dole (check mark)
Senator Durenberger (check mark)
Senator Hatch (check mark, handwritten: confirmed)
Senator Heinz - confirmed (check mark, handwritten: confirmed)
Senator Chafee - confirmed (check mark)
Senator Wilson (check mark), handwritten: confirmed
Senator Quayle (check mark), handwritten: confirmed
Sheila Burke (check mark)
Dr. James H. Sammons (check mark)
Executive Vice President
American Medical Association
535 N. Dearborn
Chicago, Illinois 60610
(312) 645-4302
Virgil S. Edwards (handwritten: confirmed), (check mark)
Administrator
Redbud Community Hospital
Redbud Hospital District
Clearlake, California
(707) 994-6486
(Contact: Larry Gage 293-8960)
Eunice Cole, President (check mark)
Judith Ryan, Executive Director (check mark)
American Nurses Association
2420 Pershing Road
Kansas City, Missouri 64108
816-474-5720
Jerome A. Crest, Administrator (check mark)
Emanuel St. Joseph's Hospital
325 Garden Boulevard
Mankato, Minnesota 56001
(Contact: Jack Owen (AHA 638-1100)
James A. Vohs (check mark)
Chairman, President and Chief Executive Officer
Kaiser Foundation Health Plan
The Ordway Building
One Kaiser Plaza
Oakland, California 94612
(415) 271-5910
Senator Packwood not coming
William S. Hotchkiss, M.D. (check mark)
Chairman, Board of Trustees
American Medical Association
2147 Old Greenbriar Road
Chesapeake, Virginia 23320
handwritten notes:
Sam (illegible)
Howard
Senior VP Public Affairs
Hospital Corp of America
1 Park Plaza
Nashville, Tennessee 37202
615-327-9551
Pres Elect of Federation
Pres Cmte on SS.
S-2017
17
-2-
(Contact: Richard Froh 296-1314)
Dr. Robert Heyssel
President
Johns Hopkins Hospital
600 North Wolfe
Baltimore, Maryland 21205
(301) 955-5667
TENTATIVE
HEALTH BREAKFAST ATTENDEES
Thursday, October 10, 8:00 a.m., Room S-230
Senator Dole (handwritten: OK)
Senator Durenberger
Senator Hatch
Senator Packwood (handwritten: no)
Senator Heinz (handwritten: OK)
Senator Chafee (handwritten: OK)
Senator Wilson
Senator Quayle
Sheila Burke
Dr. James H. Sammons
Executive Vice President
American Medical Association
535 N. Dearborn
Chicago, Illinois 60610
(312) 645-4302
Mike Bromberg's person (833-3090)
(David Jones, Humana?) (handwritten: not invited)
Virgil S. Edwards
Administrator
Redbud Community Hospital
Redbud Hospital District
Clearlake, California
(707) 994-6486
(Contact: Larry Gage 293-8960
Eunice Cole, President
Judith Ryan, Executive Director
American Nurses Association
2420 Pershing Road
Kansas City, Missouri 64108
816-474-5720
American Hospital Association
(Contact: Jack Owen 638-1100) (crossed out and replaced with Jerome A. Crest Administrator)
James A. Vohs
Chairman, President and Chief Executive Officer
Kaiser Foundation Health Plan
The Ordway Building
One Kaiser Plaza
Oakland, California 94612
handwritten note on page:
Wm S. Hotchkiss MD
Chairman
AMA
Bd. of Trustees
2147 Old Greenbriar Rd
Chesapeake VA 23320
-2-
(415) 271-5910
(Contact: Richard Froh 296-1314)
Dr. Robert Heyssel
President
Johns Hopkins Hospital
600 North Wolfe
Baltimore, Maryland 21205
(301) 955-5667
MEMORANDUM OF CALL
TO: (handwritten) Joyce
YOU WERE CALLED BY (checked)
YOU WERE VISITED BY
(handwritten: Jim Doherty
OF (Organization) 6381100
PLEASE CALL (checked) --> PHONE NO. CODE/EXT.
WILL CALL AGAIN
RETURNED YOUR CALL
IS WAITING TO SEE YOU
WISHES AN APPOINTMENT
MESSAGE (handwritten)
Am Hosp. Assoc.
H: breakfast Thurs.
RECEIVED BY (handwritten) KMR
DATE (handwritten) 10/3
TIME (handwritten) 4:00
MEMORANDUM OF CALL
TO: (handwritten) S. Burke
YOU WERE CALLED BY
YOU WERE VISITED BY
(handwritten) Deborah Knight
OF (organization) (handwritten) Dr. Heyssel
PLEASE CALL --> PHONE NO. CODE/EXT.
WILL CALL AGAIN
RETURNED YOUR CALL
IS WAITING TO SEE YOU
WISHES AN APPOINTMENT
MESSAGE (handwritten)
301-555-5667
re: breakfast
oct. 10
RECEIVED BY (handwritten) P
DATE (handwritten) 10-4
TIME (handwritten) 9:15
handwritten: tentative
HEALTH BREAKFAST ATTENDEES
Thursday, October 10, 8:00 a.m., Room S-230
Dr. James H. Sammons (handwritten: bringing someone)
Executive Vice President
American Medical Association
535 N. Dearborn
Chicago, Illinois 60610
(312) 645-4302
Mike Bromberg's person (833-3090)
(David Jones, Humana?)
Virgil S. Edwards
Administrator
Redbud Community Hospital
Redbud Hospital District
Clearlake, California
(707) 994-6486
(Contact: Larry Gage 293-8960)
Eunice Cole (handwritten: and Ryan)
President
American Nurses Association
(Contact: Judith Ryan, Executive Director 816-474-5720)
American Hospital Association
(Contact: Jack Owen 638-1100) (handwritten: (illegible) Doherty)
James A. Vohs
Chairman, President and Chief Executive Officer
Kaiser Foundation Health Plan
The Ordway Building
One Kaiser Plaza
Oakland, California 94612
(415) 271-5910
(Contact: Richard Froh 296-1314)
Dr. Robert Heyssel
President
Johns Hopkins Hospital
600 North Wolfe
Baltimore, Maryland 21205
(301) 955-5667
handwritten: Debra Knight
handwritten notes:
Dole
Durenberger
Hatch ?
Sheila Burke
Jerry Crest Administrator
Emanual St. Joseph's Hosp in Minn.
325 Garden Blv
Mankato, Minn
Jerome A. Crest 56001
Entire next page handwritten
ARMSTRONG
tony coppolino
Thursday 8:00 am
Oct 10, 1985
HEALTH BREAKFAST
- Jim Sammon MD (312) 645-4302
- AMA Board Member
Dr. James H. Sammons
Exec V.P.
AMA 5335 N. Dearborn
Chic. IL 60610
- David Jones (alex) - Humana (CONTACT MIKE BROMBERG 833-3090)
Virgil S. Edwards RH District
- Administrator Redbud Hosp (community)
Redbud, Cal. Clearlake CA 707-994-6486
contact/Larry Gage 293-8960
- American nurses drsn.
Judith Ryan
Executive Director (816) 474-5720
Eunice Cole - president
- American Hospital Assn. - CONTACT Jack Owen 638-1100
- Kaiser Foundation Health Plan
James A. Vohs Chairman, President CEO
contact: Richard Froh
Kaiser Fdtn Health Plan
The Ordway Bldg.
One Kaiser Plaza
Oakland, CA 94612
415 271-5910
- AAMC Heyssel contact Dick Knapp 828-0490
(handwritten notes at top of page)
- Judith Ryan
Executive Director
American Nurses Association
- Pam Maraldo
Executive Director
National League for Nursing
- NSQ
- Public
- Teaching
OCT 8
8 am
(illegible) home health
Cigna?
Petrocelle
Robert Van Tuyle (labeled 2, nsg hornes
Chairman
Beverly Enterprises
873 So. Fairoaks Avenue
Pasadena, California 91005
213-684-1100
Karl Bays (labeled 4)
Chairman & CEO
American Hospital Supply Corp.
One American Plaza
Evanston, Illinois 60201
312-866-4000
(bought by Baxter-Travenol not sure what his title will be)
Thomas Frist, Jr. M.D. (crossed out)
President & CEO
Hospital Corporation of America
P.O. Box 550
Nashville, Tennessee 37203
615-327-9551
Walter Weisman (crossed out)
President & Chief Operating Officer
American Medical International
414 No. Camden Drive
Beverly Hills, California 90210
213-278-6200
Charles Ewell, Ph. D. (crossed out)
President
American Health Care Systems
1205 Prospect, Suite 520
La Jolla, California 92073
Richard Knapp
Assoc. of American Medical Colleges
One Dupont Circle, N.W.
Washington, D.C. 20035
828-0400
Don L. Arnwine
President
Volunteer Hospitals of America
P.O. Box 160
Erving, Texas 75016
214-830-0000
Lewis W. Lehr (labeled 5)
Chairman & CEO
3 M Co.
3 M Center
St. Paul, Minnesota 55144
David A. Jones (labeled 1)
Chairman & CEO
Humana Inc.
P.O. Box 1438
Louisville, KY 40201
502-580-1000
Richard K. Eamer (crossed out)
Chairman & CEO
National Medical Enterprises
11620 Wilshire Blvd.
Los Angeles, California 90025
213-479-5526
Michael D. Bromberg
Executive Director
Federal of American Hospitals
1111 19th Street, N.W.
Washington, D.C. 20036
Robert A. Schoellhorn (labeled 3)
Chairman & CEO
Abbott Laboratories
Abbott Park
North Chicago, Illinois 60064
312-937-6100
notes on bottom of page:
non
prof
chain
Wagmeller
MD's
pharm (circled)
next page handwritten: ABBOTT LABS 659-8524
American Hospital Supply Corporation
1090 Vermont Avenue N.W.
Suite 210
Washington DC 20005
Telephone 202 842-3445
September 25, 1985
Ms. Sheila P. Burke
Deputy Chief of Staff
Office of the Majority Leader of the Senate
S-230 Capitol Building
Washington, D.C. 20510
Dear Sheila:
It was good talking to you last week. Karl Bays is very interested in meeting with the Majority Leader on health issues.
Mr. Bays will be out of the country for part of the week of October 7th. He will be in Washington for an Institute of Medicine meeting on October 17th and is expected to arrive in the evening on the 16th.
He is also addressing the Health Industry Manufacturers' Association on October 3rd at noon. If that date is conceivable, I could ask him to leave Chicago at 4:30 a.m. to make a breakfast meeting with the Senator.
October 17th in the morning looks like the optimal date for Mr. Bays. I know the Senator's schedule is incredibly intense and that day may not be appropriate. I do not know who the other prospective invitees are, but the Institute of Medicine meeting on the 17th draws a number of health industry leaders. I will try any other date but these look like the best so far.
On the other matter that we discussed, I would like to ask you for a few minutes of your time with Karl and me. Please give me a call on either matter at your convenience.
Best regards,
(signature)
David J. Aho, Esq.
Director Government Relations
BOB DOLE
KANSAS
United States Senate
OFFICE OF MAJORITY LEADER
S-230 THE CAPITOL
(entire page handwritten)
son
rural
sole comm.
son rural
admin. of redbud
Rn Anderson
Parkland Hosp.
Texas
entire page handwritten:
HEALTH BREAKFAST #1
- Hospital Industry
- Physicians
- Nurses
- HMO's
HEALTH BREAKFAST #2
- Pharmaceuticals
- Nursing homes
- Hospital supply/manufacturing
handwritten letter:
Sheila
Dick Knapp said that Bob Heyssel may be in Philadelphia (crossed out and replaced with Princeton) the morning of Oct 10th - if date of breakfast changes - Heyssel would like to be there.
Back up names if 10th is firm
J Robert Buchanon MD
(illegible) Mass Gen
(617) 726-2100
C. Thomas Smith
President
Yale New Haven Hospital
(203) 785-2611
entire page handwritten:
HEALTH MEETING #1
HOSPITALS -- DAVID JONES/HUMANA
MD's -- Jim Sammons, one other
Nurses
HEALTH MTG. #2
- PHARM -- ABBOTT
- Hosp supply -- DM Hosp Supply, SM
- NSG Homes -- Robert Van Tuyle
- Home Health
- HMO's -- CIGNA, Kaisser
entire page handwritten:
HOSPITALS -
AHA
A Pub Hosp -- Redbud, Parkland
AAMC --> Hopkins --> Heyssel
OOT10 Press 301-955-5667
Johns Hopkins Hosp.
FAH -- David Jones, Humana
Nurses
Physicians -
HEALTH BREAKFAST ATTENDEES
Thursday, October 10, 8:00 a.m., Room S-230
(Coffee and Breakfast in S-207)
Senator Dole
Senator Hatch (check mark)
Senator Heinz
Senator Wilson (check mark)
Senator Quayle
Sheila Burke
Dr. James H. Sammons (check mark)
Executive Vice President
American Medical Association
535 N. Dearborn
Chicago, Illinois 60610
(312) 645-4302
Virgil S. Edwards (check mark, *)
Administrator
Redbud Community Hospital
Redbud Hospital District
Clearlake, California
(707) 994-6486
Eunice Cole, President (check mark, *)
American Nurses Association
2420 Pershing Road
Kansas City, Missouri 64108
(816) 474-5720
Jerome A. Crest, President and Administrator (check mark, *)
Emanuel St. Joseph's Hospital
325 Garden Boulevard
Mankato, Minnesota 56001
James A. Vohs (check mark, *)
Chairman, President and Chief Executive Officer
Kaiser Foundation Health Plan
The Ordway Building
One Kaiser Plaza
Oakland, California 94612
(415) 271-5910
Dr. William S. Hotchkiss (check mark)
Chairman, Board of Trustees
American Medical Association
2147 Old Greenbriar Road
Chesapeake, Virginia 23320
Samuel H. Howard (check mark, *)
Senior Vice President-Public Affairs
Hospital Corporation of America
1 Park Plaza
Nashville, Tennessee 37202
(615) 327-9551
Judith Ryan, Executive Director (check mark, *)
American Nurses Association
2420 Pershing Road
Kansas City, Missouri 64108
(816) 474-5720
Dr. Robert Heyssel (check mark, *)
President
Johns Hopkins Hospital
600 North Wolfe
Baltimore, Maryland 21205
(301) 955-5667
entire page handwritten:
Vohs
Arg's sk-
need some chqs-
keep eye on himo-
risk contracts-
keep out bad guys-
quality concerns-
-costs are (illegible)
under control-
quality now the issue-
-movement of pts into
medicare risk
contracts - problem
fw Kaiser -
heyssel
we are not looking for federal govt
to bail us out-
need to give (illegible)-
-people falling
thru the cracks-
BOB DOLE
KANSAS
UNITED STATES SENATE
OFFICE OF THE MAJORITY LEADER
WASHINGTON, DC 20510
October 9, 1985
MEMORANDUM
TO: SENATOR DOLE
FROM: SHEILA BURKE
SUBJECT: HEALTH BREAKFAST
Attached is a list of confirmed attendees for tomorrow morning's scheduled breakfast.
For this first health breakfast, I included representation from the key hospital groups, the American Hospital Association, the Federation of American Hospitals, the Public Hospital Association, and the Council of Teaching Hospitals.
In addition, the two largest individual provider groups will be represented, the American Medical Association and the American Nurses Association.
The hospital representatives that will be present represent a spectrum of institutions from very small to very large, both teaching and non-teaching and proprietary and non-profit or public.
The Kaiser Health Maintenance Organization, which was also invited, is the largest HMO in the country and unlike many other HMOs, actually owns a number of hospitals in addition to operating HMOs throughout the country.
The groups have been told that the purpose of the discussion is to review current problems that have resulted from recent changes in our payment systems for the Federal health programs. Also of interest are the questions being raised about the quality of care being provided and access and sources of payments for services provided to the indigent.
Atts.
(entire page handwritten)
uncompensated - care -- howard
f impact
caid threshold
risk poor sm business
grants to specific hospitals to care for indigent
short term unemployed continuity
howard
caps = (down arrow) quality 86
(illegible) = access 87
-rural good example
-caid caps
Edwards
sm rurals
don't need all -
but some recc.-
--> tax exempt
finance
for non profit hop's -
- need access
HEALTH BREAKFAST ATTENDEES
Thursday, October 10, 8:00 a.m., Room S-230
(Coffee and Breakfast in S-207)
Dr. James H. Sammons
Executive Vice President
American Medical Association, Chicago, Illinois
- Chief Executive Officer for 10 1/2 years.
- Previously practiced family medicine in Texas for approximately 20 years.
Dr. William S. Hotchkiss
Chairman, Board of Trustees
American Medical Association, Chesapeake, Virginia
- Presently a thoracic surgeon in Chesapeake, Virginia.
- Currently a member of the attending staffs of the Leigh Memorial Hospital and Chesapeake General Hospital in Norfolk.
- Previously AMA Commissioner to the Joint Commission on the Accreditation of Hospitals before election to the Board of Trustees in 1978.
Virgil S. Edwards
Administrator
Redbud Community Hospital, Clearlake, CA
- Represents Public Hospital Association.
- Has been in the health care field for about 9 years.
- Before becoming Administrator of Redbud Community Hospital in 1984, was assistant administrator of a 398 bed hospital.
- Redbud, a 27 bed hospital located in a rural community, provides primarily medical surgical services.
- The hospital was involved in a major dispute with HHS last winter over the implementation of the DRG system and their payment levels. Part of their concerns involved the payment for services provided to the indigent.
(entire page handwritten)
- physicians refusing
to take chronic pt's-
- on theirs - they are losing millions
- 3rd yr of drq's will be the worst -->
--> drqs not reflective of real market
- the one restraint on drq's = will be malpractice -- not pro's -
Sammons
8.5M employed in health delivery system -
risk in (up arrow) unemployment -
particularly re: nurses = (down arrow) quality of care
Edwards
small rural hospitals (illegible) problems
large (illegible) of medicare/caid - drq's built on coverages
Crest
contact made i hospitals i drqs
tax exempt bonds - they need access so they can
brag about changes needed in institutions
to (up arrow) amb. services -
pt's leaving sicker/quicker -
- making arrangements to allow pt's to stay in empty
beds and pay themselves -
- may lose drq's/medicare because of this -
Samuel H. Howard
Senior Vice President - Public Affairs
Hospital Corporation of America, Nashville, Tennessee
- Represents Federation of American Hospitals.
- Served as White House Fellow to Arthur Goldberg from 1966-1967.
- Served as a member of the 1982 Advisory Council on Social Security which studied medicare program.
- An employee of Hospital Affiliate when it was acquired by Hospital Corporation of America in 1981. Was then named Senior Vice President - Public Affairs.
- HCA, a proprietary company, owns and operates 176 hospitals in the US with a total of about 29,000 beds. In addition, they manage another 190 hospitals, with 24,000 beds. They are currently located throughout the country and are present in about 35-40 states.
Eunice Cole
President
American Nurses Association, Kansas City
- Currently serving her second term as President of the American Nurses Association.
- From 1974-1976 was President of the Washington State Nurses Association.
Dr. Judith Ryan
Executive Director
American Nurses Association, Kansas City
- From 1976-1980 Dr. Ryan served as Director of Nursing Education at the Rochester Methodist Hospital in Rochester, Minnesota.
- Dr. Ryan has been with the American Nurses Association since 1980 and has been executive director since 1982.
(entire page handwritten)
2
SNF/HH taking care of sicker pt's - increased demand for nsg.
<--> services in these settings
Sammons
Hopkins/AMA (illegible) quality study
Heyssel
house/stall - under increasing pressure - frozen levels of pay -
fewer admissions
intra system changing - greater pressures (down arrow) quality
Sammons
don't force reductions in (illegible)/financing too soon -
we need quality residents
Ryan
demand for home care in community -
doing study on acuity - (up arrow) demand for nsg
services and patient population shifts -
concerns: VNA etc. being challenged by (illegible) service home health agencies -
no coordination of care -
Cole
people falling through the cracks - particularly frail
elderly -
need to look at under(illegible) traditional agencies
Vohs
competition getting wild out there - surons quality concerns -
uncompensated care becomes greater concern because
of competition
Howard
25% fewer pt's - mostly reductions in private patients -
but now also have time for medicare
Los stable now after dropping
have laid off 6,500 personnel
- bad debts 2-3% higher
- rural hosp's - not likely to survive because of drq's
-3-
Jerome A. Crest
President and Administrator
Emanuel St. Joseph's Hospital, Mankato, Minnesota
- Represents American Hospital Association.
- Has been President and Administrator of Emanuel St. Joseph's Hospital since 1984.
- Recently completed 18 months service as chairman of the Minnesota Hospital Association.
- Emanuel St. Joseph's is a 260 bed hospital which provides a broad range of services.
Dr. Robert Heyssel
President
Johns Hopkins Hospital, Baltimore, Maryland
- Represents American Association of Medical Colleges, Council of Teaching Hospitals
- Named President in July 1983 after serving as Executive Vice President and Director since 1972.
- Is professor of Medicine at Johns Hopkins School of Medicine.
- Headed an Institute of Medicine Committee on controlling the supply of beds and a National Academy of Sicnes Committee regarding emergency medical services.
- Hopkins is a very large, 1069 bed, major teaching facility providing a broad range of services.
James A. Vohs
Chairman, President and CEO
Kaiser Foundation Health Plan
- Mr. Vohs has been with the Kaiser Foundation Health Plan since 1952.
- Kaiser has approximately 4.7 million enrollees nationwide. The organization is organized into 12 regions and is present in 15 states.
- Kaiser recently purchased an HMO in Kansas City which is affiliated with the University of Kansas Medical Center. They currently have about 9,300 enrollees.
(entire page handwritten)
hurig
(illegible)
recon
waiver
no fee freeze
Quayle
GME
FMG's -
maldrotib. of (illegible)'s primary care
Wilson
nsg. homes/qual.
pps - quality/aged
quality of care in military
concurrent/prospective quality ck - not retrospective
Hotchkiss
fee freeze/congress
breaking contract
don't like pal/non-pal - old mix
hatch/md's claiming they will request pt's
Hotchkiss - not wide spread - competition growing
Sammons
not widespread - but real concern re: access/accountability
drq's - counterproductive re: liability/quality - (up arrow) malpractice - cosponsor hatch
Hatch
malpractice = too much care as protection
Hurig
drq's create opportunity for malpractice
Sammons
we're sending them home sicker/quicker
Heyssel
- old don't like being sent home from ambulatory surgery - need to
loosen up on amb surg rules
- drq's don't measure what they are supposed to --
- people fall out of averages -
higher costs of teaching hospitals
14% educational costs
Ryan
impact on nsg - drq's don't look @ nsg resource use -
shorter length of stay reduces ability to
prepare pt's for home
HEALTH BREAKFAST ATTENDEES
Thursday, October 10, 8:00 a.m., Room S-230
(Coffee and Breakfast in S-207)
Dr. James H. Sammons
Executive Vice President
American Medical Association, Chicago, Illinois
- Chief Executive Officer for 10 1/2 years.
- Previously practiced family medicine in Texas for approximately 20 years.
Dr. William S. Hotchkiss
Chairman, Board of Trustees
American Medical Association, Chesapeake, Virginia
- Presently a thoracic surgeon in Chesapeake, Virginia.
- Currently a member of the attending staffs of the Leigh Memorial Hospital and Chesapeake General Hospital in Norfolk.
- Previously AMA Commissioner to the Joint Commission on the Accreditation of Hospitals before election to the Board of Trustees in 1978.
Virgil S. Edwards
Administrator
Redbud Community Hospital, Clearlake, CA
- Represents Public Hospital Association.
- Has been in the health care field for about 9 years.
- Before becoming Administrator of Redbud Community Hospital in 1984, was assistant administrator of a 398 bed hospital.
- Redbud, a 27 bed hospital located in a rural community, provides primarily medical surgical services.
- The hospital was involved in a major dispute with HHS last winter over the implementation of the DRG system and their payment levels. Part of their concerns involved the payment for services provided to the indigent.
-2-
Samuel H. Howard
Senior Vice President - Public Affairs
Hospital Corporation of America, Nashville, Tennessee
- Represents Federation of American Hospitals.
- Served as White House Fellow to Arthur Goldberg from 1966-1967.
- Served as a member of the 1982 Advisory Council on Social Security which studied medicare program.
- An employee of Hospital Affiliate when it was acquired by Hospital Corporation of America in 1981. Was then named Senior Vice President - Public Affairs.
- HCA, a proprietary company, owns and operates 176 hospitals in the US with a total of about 29,000 beds. In addition, they manage another 190 hospitals, with 24,000 beds. They are currently located throughout the country and are present in about 35-40 states.
Eunice Cole
President
American Nurses Association, Kansas City
- Currently serving her second term as President of the American Nurses Association.
- From 1974-1976 was President of the Washington State Nurses Association.
Dr. Judith Ryan
Executive Director
American Nurses Association, Kansas City
- From 1976-1980 Dr. Ryan served as Director of Nursing Education at the Rochester Methodist Hospital in Rochester, Minnesota.
- Dr. Ryan has been with the American Nurses Association since 1980 and has been executive director since 1982.
-3-
Jerome A. Crest
President and Administrator
Emanuel St. Joseph's Hospital, Mankato, Minnesota
- Represents American Hospital Association.
- Has been President and Administrator of Emanuel St. Joseph's Hospital since 1984.
- Recently completed 18 months service as chairman of the Minnesota Hospital Association.
- Emanuel St. Joseph's is a 260 bed hospital which provides a broad range of services.
Dr. Robert Heyssel
President
Johns Hopkins Hospital, Baltimore, Maryland
- Represents American Association of Medical Colleges, Council of Teaching Hospitals
- Named President in July 1983 after serving as Executive Vice President and Director since 1972.
- Is professor of Medicine at Johns Hopkins School of Medicine.
- Headed an Institute of Medicine Committee on controlling the supply of beds and a National Academy of Sicnes Committee regarding emergency medical services.
- Hopkins is a very large, 1069 bed, major teaching facility providing a broad range of services.
James A. Vohs
Chairman, President and CEO
Kaiser Foundation Health Plan
- Mr. Vohs has been with the Kaiser Foundation Health Plan since 1952.
- Kaiser has approximately 4.7 million enrollees nationwide. The organization is organized into 12 regions and is present in 15 states.
- Kaiser recently purchased an HMO in Kansas City which is affiliated with the University of Kansas Medical Center. They currently have about 9,300 enrollees.
UNITED STATES SENATE
OFFICE OF THE MAJORITY LEADER
WASHINGTON, DC
BOB DOLE
KANSAS
October 15, 1985
Dear Mrs. Cole:
Thank you for attending last Thursday's breakfast meeting here in Washington. I am sorry that I was delayed but enjoyed the opportunity to meet with you following your discussion with Senators Heinz, Quayle, Wilson, and Hatch.
I particularly appreciated your comments on the need to undergird our traditional home health agencies. These services have become increasingly important as we create incentives for beneficiaries to be discharged earlier, or simply remain at home, for the majority of their care.
Clearly also of concern is the care of those who "fall through the cracks" of traditional financing mechanisms. We will continue to seek out ways to care for these individuals without further adding to our deficit problems.
I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance.
Sincerely yours,
(signature)
Bob Dole
Mrs. Eunice Cole
President
American Nurses Association
2420 Pershing Road
Kansas City, Missouri 64108
UNITED STATES SENATE
OFFICE OF THE MAJORITY LEADER
WASHINGTON, DC
BOB DOLE
KANSAS
October 15, 1985
Dear Dr. Hotchkiss:
Thank you for your willingness to attend the breakfast meeting last week. I am sorry I was delayed and unable to join you but understand that the discussion was very useful.
I know you are particularly concerned with the continuation of the fee freeze and the participating physician program. Unfortunately, our continued battle to reduce the Federal deficit has again forced us to make a number of very difficult decisions. I can understand your frustration with what appears to be the breaking of an agreement with respect to the freeze, but you must also understand our dilemma with a projected deficit in excess of $170 billion.
Over the long term, I agree that together we must begin to seriously examine payment reform. We have a responsibility to both the medicare beneficiary and to the physicians nationwide who care for these patients, to
-2-
create a reasonable and equitable payment system.
I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance.
Sincerely yours,
(signature)
BOB DOLE
Majority Leader
Dr. William S. Hotchkiss
Chairman, Board of Trustees
American Medical Association
2147 Old Greenbriar Road
Chesapeake, Virginia 23320
UNITED STATES SENATE
OFFICE OF THE MAJORITY LEADER
WASHINGTON, DC
BOB DOLE
KANSAS
October 15, 1985
Dear Dr. Ryan:
Thank you for attending last Thursday's breakfast meeting here in Washington. I am sorry that I was delayed but enjoyed the opportunity to meet with you following your discussion with Senators Heinz, Quayle, Wilson, and Hatch.
I was particularly interested to learn of your ongoing survey of home health agencies and your intention of learning more about the acuity of the patient mix and the resulting nursing service needs. It has been clear to me for some time, particularly since the implementation of the Prospective Payment System, that attention needed to be given to both home health care service providers and nursing home service providers. It may well be time to reexamine the design and financing of these benefits. Patient care needs seemed to have changed as has our capacity to care for people in non-institutional settings. As we continue to urge reductions in the use
-2-
of inpatient services, we must make an effort to assure that quality, alternative services are readily available.
I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance.
Sincerely yours,
(signature)
BOB DOLE
Majority Leader
Dr. Judith Ryan
Executive Director
American Nurses Association
2420 Pershing Road
Kansas City, Missouri 64108
UNITED STATES SENATE
OFFICE OF THE MAJORITY LEADER
WASHINGTON, DC
BOB DOLE
KANSAS
October 15, 1985
Dear Jim:
Thank you for attending last Thursday's breakfast meeting here in Washington. I am sorry that I was delayed but enjoyed the opportunity to meet with you following your discussion with Senators Heinz, Quayle, Wilson, and Hatch.
I particularly appreciated your comments regarding the need to keep a close eye on the quality of the health care services provided to the elderly. As you point out, this is especially true with respect to certain prepaid health plans. We cannot afford a repeat of the problems documented in California in the 1970's.
Of course, on the non-HMO side, we must be equally as vigilant. The Prospective Payment System has achieved a great deal in bringing about reductions in cost and lengths of stay, but neither of these
-2-
achievements can overcome serious quality of care issues should they occur.
I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance.
Sincerely yours,
(signature)
BOB DOLE
Majority Leader
James A. Vohs
Chairman, President, and Chief Executive Officer
Kaiser Foundation Health Plan
The Ordway Building
One Kaiser Plaza
Oakland, California 94612
UNITED STATES SENATE
OFFICE OF THE MAJORITY LEADER
WASHINGTON, DC
BOB DOLE
KANSAS
October 15, 1985
Dear Mr. Edwards:
Thank you for attending last Thursday's breakfast meeting here in Washington. I am sorry that I was delayed but enjoyed the opportunity to meet with you following your discussion with Senators Heinz, Quayle, Wilson, and Hatch.
I particularly appreciated hearing your concerns about the survival of small rural hospitals and the need of certain institutions for continued access to tax exempt bonds.
With respect to rural hospitals, it was clear from the outset of the Prospective Payment System that we might well need to make adjustments. As you know, the Department was directed to prepare a study on the need to make adjustments for small rural hospitals; the results are not due for some months however. In the interim, I would be very interested in your thoughts on how best to isolate some of the legitimate needs of these institutions and address them.
With respect to tax exempt bonds, as I indicated in our discussion, it appears unlikely that the tax reform bill will see
-2-
action in the Senate this year. However, in anticipation of these discussions, I will review carefully the current use of this authority and its value to non-profit institutions like your own.
I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance.
Sincerely yours,
(signature)
BOB DOLE
Majority Leader
Virgil S. Edwards
Administrator
Redbud Community Hospital
Redbud Hospital District
Clearlake, California 95422
UNITED STATES SENATE
OFFICE OF THE MAJORITY LEADER
WASHINGTON, DC
BOB DOLE
KANSAS
October 15, 1985
Dear Mr. Crest:
Thank you for attending last Thursday's breakfast meeting here in Washington. I am sorry that I was delayed but enjoyed the opportunity to meet with you following your discussion with Senators Heinz, Quayle, Wilson, and Hatch.
I particularly appreciated hearing your concerns about the survival of small rural hospitals. It was clear from the outset of the Prospective Payment System that we might well need to make a limited number of adjustments to meet certain specific needs. To assist us, as you know, the Department was directed to prepare a study on the needs of small rural hospitals; the results are not due for some months however. In the interim, I would be very interested in your thoughts on how best to isolate some of the legitimate needs of these institutions and address them.
I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance.
Sincerely yours,
(signature)
BOB DOLE
Majority Leader
Jerome A. Crest
President and Administrator
Emanuel St. Joseph's Hospital
325 Garden Boulevard
Mankato, Minnesota 56001
UNITED STATES SENATE
OFFICE OF THE MAJORITY LEADER
WASHINGTON, DC
BOB DOLE
KANSAS
October 15, 1985
Dear Dr. Heyssel:
Thank you for attending last Thursday's breakfast meeting here in Washington. I am sorry that I was delayed but enjoyed the opportunity to meet with you following your discussion with Senators Heinz, Quayle, Wilson, and Hatch.
I particularly appreciated your comments on the need to find a method of financing care for those without access to any financial support. As I mentioned, considerable time was spent on a bill last year which dealt with the insurance needs of the unemployed. Though we were unable to secure passage at that time, we may be well served by a review of that initiative once again. However, as you pointed out, the problem is not simply a Federal issue, but rather one that needs the attention of all.
I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance.
Sincerely yours,
(signature)
BOB DOLE
Majority Leader
Dr. Robert Heyssel
President
Johns Hopkins Hospital
600 North Wolfe
Baltimore, Maryland 21205
UNITED STATES SENATE
OFFICE OF THE MAJORITY LEADER
WASHINGTON, DC
BOB DOLE
KANSAS
October 15, 1985
Dear Jim:
Thanks for taking the time to attend last week's breakfast meeting. Unfortunately, I was unavoidably delayed and missed getting the chance to talk with you, however, I understand the discussion went quite well.
Like you, I am concerned that as we continue to try to bring health care costs under control, we keep a close eye on the quality of care being provided to medicare beneficiaries nationwide. I urge you to let me know if you have any particular concerns that we should address at this time and look forward to seeing you in the near future.
Sincerely yours,
(signature)
BOB DOLE
Majority Leader
Dr. James H. Sammons
Executive Vice President
American Medical Association
535 N. Dearborn
Chicago, Illinois 60610
UNITED STATES SENATE
OFFICE OF THE MAJORITY LEADER
WASHINGTON, DC
BOB DOLE
KANSAS
October 15, 1985
Dear Sam:
Thank you for attending last Thursday's breakfast meeting here in Washington. I am sorry that I was delayed but enjoyed the opportunity to meet with you following your discussion with Senators Heinz, Quayle, Wilson, and Hatch.
I particularly appreciated your comments on the need to find a method of financing care for those without access to any financial support. As I mentioned, considerable time was spent on a bill last year which dealt with the insurance needs of the unemployed. Though we were unable to secure passage at that time, we may be well served by a review of that initiative once again. However, as you pointed out, the problem is not simply a Federal issue, but rather one that needs the attention of all.
I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance.
Sincerely yours,
(signature)
BOB DOLE
Majority Leader
Samuel H. Howard
Senior Vice President - Public Affairs
Hospital Corporation of America
1 Park Plaza
Nashville, Tennessee 37202
HEALTH BREAKFAST ATTENDEES
Thursday, October 10, 8:00 a.m., Room S-230 (handwritten: Hotchkiss)
(Coffee and Breakfast in S-207)
handwritten in top margins: Chall, (illegible), Dole, Vohs, Wils, Edward, Heinz, Cole, Hatch, Heyssel, Quayle
Senator Dole
Senator Hatch
Senator Heinz
Senator Wilson (check mark)
Senator Quayle (check mark)
Sheila Burke
Dr. James H. Sammons
Executive Vice President
American Medical Association
535 N. Dearborn
Chicago, Illinois 60610
(312) 645-4302
Virgil S. Edwards
Administrator
Redbud Community Hospital
Redbud Hospital District
Clearlake, California
(707) 994-6486
Eunice Cole, President
American Nurses Association
2420 Pershing Road
Kansas City, Missouri 64108
(816) 474-5720
Jerome A. Crest, President and Administrator
Emanuel St. Joseph's Hospital
325 Garden Boulevard
Mankato, Minnesota 56001
James A. Vohs
Chairman, President and Chief Executive Officer
Kaiser Foundation Health Plan
The Ordway Building
One Kaiser Plaza
Oakland, California 94612
(415) 271-5910
Dr. William S. Hotchkiss
Chairman, Board of Trustees
American Medical Association
2147 Old Greenbriar Road
Chesapeake, Virginia 23320
Samuel H. Howard
Senior Vice President - Public Affairs
Hospital Corporation of America
1 Park Plaza
Nashville, Tennessee 37202
(615) 327-9551
Judith Ryan, Executive Director
American Nurses Association
2420 Pershing Road
Kansas City, Missouri 64108
(816) 474-5720
Dr. Robert Heyssel
President
Johns Hopkins Hospital
600 North Wolfe
Baltimore, Maryland 21205
(301) 955-5667
only note on page (handwritten): Thursday; 3; dole
TENTATIVE
HEALTH BREAKFAST ATTENDEES
Thursday, October 10, 8:00 a.m., Room S-230
(Coffee and Breakfast in S-207)
handwritten at top of page: Packwood, Chafee
Senator Dole (handwritten: confirmed)
Senator Durenberger (handwritten: ?)
Senator Hatch (handwritten: Cindy - 135 Russell)
Senator Heinz (handwritten: confirmed)
Senator Chafee (crossed out)
Senator Wilson (handwritten: Dottie w/c/b)
Senator Quayle (handwritten: Cynthia w/c/b - SH - 524)
Sheila Burke (handwritten: confirmed)
Dr. James H. Sammons (handwritten: MD, confirmed)
Executive Vice President
American Medical Association
535 N. Dearborn
Chicago, Illinois 60610
(312) 645-4302
Virgil S. Edwards (handwritten: confirmed)
Administrator
Redbud Community Hospital
Redbud Hospital District
Clearlake, California
(707) 994-6486
Eunice Cole, President (handwritten: conf.)
American Nurses Association
2420 Pershing Road
Kansas City, Missouri 64108
(816) 474-5720
Jerome A. Crest, Administrator (handwritten: conf.)
Emanuel St. Joseph's Hospital
325 Garden Boulevard
Mankato, Minnesota 56001
James A. Vohs (handwritten: conf.)
Chairman, President and Chief Executive Officer
Kaiser Foundation Health Plan
The Ordway Building
One Kaiser Plaza
Oakland, California 94612
(415) 271-5910
handwritten note: 1:15-9:15 tonight, Sheraton Grand
William H. Hotchkiss, MD (handwritten: confirmed)
Chairman, Board of Trustees
American Medical Association
2147 Old Greenbriar Road
Chesapeake, Virginia 23320
Samuel H. Howard (handwritten: conf.)
Senior Vice President - Public Affairs
Hospital Corporation of America
1 Park Plaza
Nashville, Tennessee 37202
(615) 327-9551
Judith Ryan, Executive Director (handwritten: conf.)
American Nurses Association
2420 Pershing Road
Kansas City, Missouri 64108
(816) 474-5720
Dr. Robert Heyssel (handwritten: conf.)
President
Johns Hopkins Hospital
600 North Wolfe
Baltimore, Maryland 21205
(301) 955-5667
TENTATIVE (outlined)
HEALTH BREAKFAST ATTENDEES
Thursday, October 10, 8:00 a.m., Room S-230
Senator Dole (check mark)
Senator Durenberger (check mark)
Senator Hatch (check mark, handwritten: confirmed)
Senator Heinz - confirmed (check mark, handwritten: confirmed)
Senator Chafee - confirmed (check mark)
Senator Wilson (check mark), handwritten: confirmed
Senator Quayle (check mark), handwritten: confirmed
Sheila Burke (check mark)
Dr. James H. Sammons (check mark)
Executive Vice President
American Medical Association
535 N. Dearborn
Chicago, Illinois 60610
(312) 645-4302
Virgil S. Edwards (handwritten: confirmed), (check mark)
Administrator
Redbud Community Hospital
Redbud Hospital District
Clearlake, California
(707) 994-6486
(Contact: Larry Gage 293-8960)
Eunice Cole, President (check mark)
Judith Ryan, Executive Director (check mark)
American Nurses Association
2420 Pershing Road
Kansas City, Missouri 64108
816-474-5720
Jerome A. Crest, Administrator (check mark)
Emanuel St. Joseph's Hospital
325 Garden Boulevard
Mankato, Minnesota 56001
(Contact: Jack Owen (AHA 638-1100)
James A. Vohs (check mark)
Chairman, President and Chief Executive Officer
Kaiser Foundation Health Plan
The Ordway Building
One Kaiser Plaza
Oakland, California 94612
(415) 271-5910
Senator Packwood not coming
William S. Hotchkiss, M.D. (check mark)
Chairman, Board of Trustees
American Medical Association
2147 Old Greenbriar Road
Chesapeake, Virginia 23320
handwritten notes:
Sam (illegible)
Howard
Senior VP Public Affairs
Hospital Corp of America
1 Park Plaza
Nashville, Tennessee 37202
615-327-9551
Pres Elect of Federation
Pres Cmte on SS.
S-2017
17
-2-
(Contact: Richard Froh 296-1314)
Dr. Robert Heyssel
President
Johns Hopkins Hospital
600 North Wolfe
Baltimore, Maryland 21205
(301) 955-5667
TENTATIVE
HEALTH BREAKFAST ATTENDEES
Thursday, October 10, 8:00 a.m., Room S-230
Senator Dole (handwritten: OK)
Senator Durenberger
Senator Hatch
Senator Packwood (handwritten: no)
Senator Heinz (handwritten: OK)
Senator Chafee (handwritten: OK)
Senator Wilson
Senator Quayle
Sheila Burke
Dr. James H. Sammons
Executive Vice President
American Medical Association
535 N. Dearborn
Chicago, Illinois 60610
(312) 645-4302
Mike Bromberg's person (833-3090)
(David Jones, Humana?) (handwritten: not invited)
Virgil S. Edwards
Administrator
Redbud Community Hospital
Redbud Hospital District
Clearlake, California
(707) 994-6486
(Contact: Larry Gage 293-8960
Eunice Cole, President
Judith Ryan, Executive Director
American Nurses Association
2420 Pershing Road
Kansas City, Missouri 64108
816-474-5720
American Hospital Association
(Contact: Jack Owen 638-1100) (crossed out and replaced with Jerome A. Crest Administrator)
James A. Vohs
Chairman, President and Chief Executive Officer
Kaiser Foundation Health Plan
The Ordway Building
One Kaiser Plaza
Oakland, California 94612
handwritten note on page:
Wm S. Hotchkiss MD
Chairman
AMA
Bd. of Trustees
2147 Old Greenbriar Rd
Chesapeake VA 23320
-2-
(415) 271-5910
(Contact: Richard Froh 296-1314)
Dr. Robert Heyssel
President
Johns Hopkins Hospital
600 North Wolfe
Baltimore, Maryland 21205
(301) 955-5667
MEMORANDUM OF CALL
TO: (handwritten) Joyce
YOU WERE CALLED BY (checked)
YOU WERE VISITED BY
(handwritten: Jim Doherty
OF (Organization) 6381100
PLEASE CALL (checked) --> PHONE NO. CODE/EXT.
WILL CALL AGAIN
RETURNED YOUR CALL
IS WAITING TO SEE YOU
WISHES AN APPOINTMENT
MESSAGE (handwritten)
Am Hosp. Assoc.
H: breakfast Thurs.
RECEIVED BY (handwritten) KMR
DATE (handwritten) 10/3
TIME (handwritten) 4:00
MEMORANDUM OF CALL
TO: (handwritten) S. Burke
YOU WERE CALLED BY
YOU WERE VISITED BY
(handwritten) Deborah Knight
OF (organization) (handwritten) Dr. Heyssel
PLEASE CALL --> PHONE NO. CODE/EXT.
WILL CALL AGAIN
RETURNED YOUR CALL
IS WAITING TO SEE YOU
WISHES AN APPOINTMENT
MESSAGE (handwritten)
301-555-5667
re: breakfast
oct. 10
RECEIVED BY (handwritten) P
DATE (handwritten) 10-4
TIME (handwritten) 9:15
handwritten: tentative
HEALTH BREAKFAST ATTENDEES
Thursday, October 10, 8:00 a.m., Room S-230
Dr. James H. Sammons (handwritten: bringing someone)
Executive Vice President
American Medical Association
535 N. Dearborn
Chicago, Illinois 60610
(312) 645-4302
Mike Bromberg's person (833-3090)
(David Jones, Humana?)
Virgil S. Edwards
Administrator
Redbud Community Hospital
Redbud Hospital District
Clearlake, California
(707) 994-6486
(Contact: Larry Gage 293-8960)
Eunice Cole (handwritten: and Ryan)
President
American Nurses Association
(Contact: Judith Ryan, Executive Director 816-474-5720)
American Hospital Association
(Contact: Jack Owen 638-1100) (handwritten: (illegible) Doherty)
James A. Vohs
Chairman, President and Chief Executive Officer
Kaiser Foundation Health Plan
The Ordway Building
One Kaiser Plaza
Oakland, California 94612
(415) 271-5910
(Contact: Richard Froh 296-1314)
Dr. Robert Heyssel
President
Johns Hopkins Hospital
600 North Wolfe
Baltimore, Maryland 21205
(301) 955-5667
handwritten: Debra Knight
handwritten notes:
Dole
Durenberger
Hatch ?
Sheila Burke
Jerry Crest Administrator
Emanual St. Joseph's Hosp in Minn.
325 Garden Blv
Mankato, Minn
Jerome A. Crest 56001
Entire next page handwritten
ARMSTRONG
tony coppolino
Thursday 8:00 am
Oct 10, 1985
HEALTH BREAKFAST
- Jim Sammon MD (312) 645-4302
- AMA Board Member
Dr. James H. Sammons
Exec V.P.
AMA 5335 N. Dearborn
Chic. IL 60610
- David Jones (alex) - Humana (CONTACT MIKE BROMBERG 833-3090)
Virgil S. Edwards RH District
- Administrator Redbud Hosp (community)
Redbud, Cal. Clearlake CA 707-994-6486
contact/Larry Gage 293-8960
- American nurses drsn.
Judith Ryan
Executive Director (816) 474-5720
Eunice Cole - president
- American Hospital Assn. - CONTACT Jack Owen 638-1100
- Kaiser Foundation Health Plan
James A. Vohs Chairman, President CEO
contact: Richard Froh
Kaiser Fdtn Health Plan
The Ordway Bldg.
One Kaiser Plaza
Oakland, CA 94612
415 271-5910
- AAMC Heyssel contact Dick Knapp 828-0490
(handwritten notes at top of page)
- Judith Ryan
Executive Director
American Nurses Association
- Pam Maraldo
Executive Director
National League for Nursing
- NSQ
- Public
- Teaching
OCT 8
8 am
(illegible) home health
Cigna?
Petrocelle
Robert Van Tuyle (labeled 2, nsg hornes
Chairman
Beverly Enterprises
873 So. Fairoaks Avenue
Pasadena, California 91005
213-684-1100
Karl Bays (labeled 4)
Chairman & CEO
American Hospital Supply Corp.
One American Plaza
Evanston, Illinois 60201
312-866-4000
(bought by Baxter-Travenol not sure what his title will be)
Thomas Frist, Jr. M.D. (crossed out)
President & CEO
Hospital Corporation of America
P.O. Box 550
Nashville, Tennessee 37203
615-327-9551
Walter Weisman (crossed out)
President & Chief Operating Officer
American Medical International
414 No. Camden Drive
Beverly Hills, California 90210
213-278-6200
Charles Ewell, Ph. D. (crossed out)
President
American Health Care Systems
1205 Prospect, Suite 520
La Jolla, California 92073
Richard Knapp
Assoc. of American Medical Colleges
One Dupont Circle, N.W.
Washington, D.C. 20035
828-0400
Don L. Arnwine
President
Volunteer Hospitals of America
P.O. Box 160
Erving, Texas 75016
214-830-0000
Lewis W. Lehr (labeled 5)
Chairman & CEO
3 M Co.
3 M Center
St. Paul, Minnesota 55144
David A. Jones (labeled 1)
Chairman & CEO
Humana Inc.
P.O. Box 1438
Louisville, KY 40201
502-580-1000
Richard K. Eamer (crossed out)
Chairman & CEO
National Medical Enterprises
11620 Wilshire Blvd.
Los Angeles, California 90025
213-479-5526
Michael D. Bromberg
Executive Director
Federal of American Hospitals
1111 19th Street, N.W.
Washington, D.C. 20036
Robert A. Schoellhorn (labeled 3)
Chairman & CEO
Abbott Laboratories
Abbott Park
North Chicago, Illinois 60064
312-937-6100
notes on bottom of page:
non
prof
chain
Wagmeller
MD's
pharm (circled)
next page handwritten: ABBOTT LABS 659-8524
American Hospital Supply Corporation
1090 Vermont Avenue N.W.
Suite 210
Washington DC 20005
Telephone 202 842-3445
September 25, 1985
Ms. Sheila P. Burke
Deputy Chief of Staff
Office of the Majority Leader of the Senate
S-230 Capitol Building
Washington, D.C. 20510
Dear Sheila:
It was good talking to you last week. Karl Bays is very interested in meeting with the Majority Leader on health issues.
Mr. Bays will be out of the country for part of the week of October 7th. He will be in Washington for an Institute of Medicine meeting on October 17th and is expected to arrive in the evening on the 16th.
He is also addressing the Health Industry Manufacturers' Association on October 3rd at noon. If that date is conceivable, I could ask him to leave Chicago at 4:30 a.m. to make a breakfast meeting with the Senator.
October 17th in the morning looks like the optimal date for Mr. Bays. I know the Senator's schedule is incredibly intense and that day may not be appropriate. I do not know who the other prospective invitees are, but the Institute of Medicine meeting on the 17th draws a number of health industry leaders. I will try any other date but these look like the best so far.
On the other matter that we discussed, I would like to ask you for a few minutes of your time with Karl and me. Please give me a call on either matter at your convenience.
Best regards,
(signature)
David J. Aho, Esq.
Director Government Relations
BOB DOLE
KANSAS
United States Senate
OFFICE OF MAJORITY LEADER
S-230 THE CAPITOL
(entire page handwritten)
son
rural
sole comm.
son rural
admin. of redbud
Rn Anderson
Parkland Hosp.
Texas
entire page handwritten:
HEALTH BREAKFAST #1
- Hospital Industry
- Physicians
- Nurses
- HMO's
HEALTH BREAKFAST #2
- Pharmaceuticals
- Nursing homes
- Hospital supply/manufacturing
handwritten letter:
Sheila
Dick Knapp said that Bob Heyssel may be in Philadelphia (crossed out and replaced with Princeton) the morning of Oct 10th - if date of breakfast changes - Heyssel would like to be there.
Back up names if 10th is firm
J Robert Buchanon MD
(illegible) Mass Gen
(617) 726-2100
C. Thomas Smith
President
Yale New Haven Hospital
(203) 785-2611
entire page handwritten:
HEALTH MEETING #1
HOSPITALS -- DAVID JONES/HUMANA
MD's -- Jim Sammons, one other
Nurses
HEALTH MTG. #2
- PHARM -- ABBOTT
- Hosp supply -- DM Hosp Supply, SM
- NSG Homes -- Robert Van Tuyle
- Home Health
- HMO's -- CIGNA, Kaisser
entire page handwritten:
HOSPITALS -
AHA
A Pub Hosp -- Redbud, Parkland
AAMC --> Hopkins --> Heyssel
OOT10 Press 301-955-5667
Johns Hopkins Hosp.
FAH -- David Jones, Humana
Nurses
Physicians -
HEALTH BREAKFAST ATTENDEES
Thursday, October 10, 8:00 a.m., Room S-230
(Coffee and Breakfast in S-207)
Senator Dole
Senator Hatch (check mark)
Senator Heinz
Senator Wilson (check mark)
Senator Quayle
Sheila Burke
Dr. James H. Sammons (check mark)
Executive Vice President
American Medical Association
535 N. Dearborn
Chicago, Illinois 60610
(312) 645-4302
Virgil S. Edwards (check mark, *)
Administrator
Redbud Community Hospital
Redbud Hospital District
Clearlake, California
(707) 994-6486
Eunice Cole, President (check mark, *)
American Nurses Association
2420 Pershing Road
Kansas City, Missouri 64108
(816) 474-5720
Jerome A. Crest, President and Administrator (check mark, *)
Emanuel St. Joseph's Hospital
325 Garden Boulevard
Mankato, Minnesota 56001
James A. Vohs (check mark, *)
Chairman, President and Chief Executive Officer
Kaiser Foundation Health Plan
The Ordway Building
One Kaiser Plaza
Oakland, California 94612
(415) 271-5910
Dr. William S. Hotchkiss (check mark)
Chairman, Board of Trustees
American Medical Association
2147 Old Greenbriar Road
Chesapeake, Virginia 23320
Samuel H. Howard (check mark, *)
Senior Vice President-Public Affairs
Hospital Corporation of America
1 Park Plaza
Nashville, Tennessee 37202
(615) 327-9551
Judith Ryan, Executive Director (check mark, *)
American Nurses Association
2420 Pershing Road
Kansas City, Missouri 64108
(816) 474-5720
Dr. Robert Heyssel (check mark, *)
President
Johns Hopkins Hospital
600 North Wolfe
Baltimore, Maryland 21205
(301) 955-5667
entire page handwritten:
Vohs
Arg's sk-
need some chqs-
keep eye on himo-
risk contracts-
keep out bad guys-
quality concerns-
-costs are (illegible)
under control-
quality now the issue-
-movement of pts into
medicare risk
contracts - problem
fw Kaiser -
heyssel
we are not looking for federal govt
to bail us out-
need to give (illegible)-
-people falling
thru the cracks-
BOB DOLE
KANSAS
UNITED STATES SENATE
OFFICE OF THE MAJORITY LEADER
WASHINGTON, DC 20510
October 9, 1985
MEMORANDUM
TO: SENATOR DOLE
FROM: SHEILA BURKE
SUBJECT: HEALTH BREAKFAST
Attached is a list of confirmed attendees for tomorrow morning's scheduled breakfast.
For this first health breakfast, I included representation from the key hospital groups, the American Hospital Association, the Federation of American Hospitals, the Public Hospital Association, and the Council of Teaching Hospitals.
In addition, the two largest individual provider groups will be represented, the American Medical Association and the American Nurses Association.
The hospital representatives that will be present represent a spectrum of institutions from very small to very large, both teaching and non-teaching and proprietary and non-profit or public.
The Kaiser Health Maintenance Organization, which was also invited, is the largest HMO in the country and unlike many other HMOs, actually owns a number of hospitals in addition to operating HMOs throughout the country.
The groups have been told that the purpose of the discussion is to review current problems that have resulted from recent changes in our payment systems for the Federal health programs. Also of interest are the questions being raised about the quality of care being provided and access and sources of payments for services provided to the indigent.
Atts.
(entire page handwritten)
uncompensated - care -- howard
f impact
caid threshold
risk poor sm business
grants to specific hospitals to care for indigent
short term unemployed continuity
howard
caps = (down arrow) quality 86
(illegible) = access 87
-rural good example
-caid caps
Edwards
sm rurals
don't need all -
but some recc.-
--> tax exempt
finance
for non profit hop's -
- need access
HEALTH BREAKFAST ATTENDEES
Thursday, October 10, 8:00 a.m., Room S-230
(Coffee and Breakfast in S-207)
Dr. James H. Sammons
Executive Vice President
American Medical Association, Chicago, Illinois
- Chief Executive Officer for 10 1/2 years.
- Previously practiced family medicine in Texas for approximately 20 years.
Dr. William S. Hotchkiss
Chairman, Board of Trustees
American Medical Association, Chesapeake, Virginia
- Presently a thoracic surgeon in Chesapeake, Virginia.
- Currently a member of the attending staffs of the Leigh Memorial Hospital and Chesapeake General Hospital in Norfolk.
- Previously AMA Commissioner to the Joint Commission on the Accreditation of Hospitals before election to the Board of Trustees in 1978.
Virgil S. Edwards
Administrator
Redbud Community Hospital, Clearlake, CA
- Represents Public Hospital Association.
- Has been in the health care field for about 9 years.
- Before becoming Administrator of Redbud Community Hospital in 1984, was assistant administrator of a 398 bed hospital.
- Redbud, a 27 bed hospital located in a rural community, provides primarily medical surgical services.
- The hospital was involved in a major dispute with HHS last winter over the implementation of the DRG system and their payment levels. Part of their concerns involved the payment for services provided to the indigent.
(entire page handwritten)
- physicians refusing
to take chronic pt's-
- on theirs - they are losing millions
- 3rd yr of drq's will be the worst -->
--> drqs not reflective of real market
- the one restraint on drq's = will be malpractice -- not pro's -
Sammons
8.5M employed in health delivery system -
risk in (up arrow) unemployment -
particularly re: nurses = (down arrow) quality of care
Edwards
small rural hospitals (illegible) problems
large (illegible) of medicare/caid - drq's built on coverages
Crest
contact made i hospitals i drqs
tax exempt bonds - they need access so they can
brag about changes needed in institutions
to (up arrow) amb. services -
pt's leaving sicker/quicker -
- making arrangements to allow pt's to stay in empty
beds and pay themselves -
- may lose drq's/medicare because of this -
Samuel H. Howard
Senior Vice President - Public Affairs
Hospital Corporation of America, Nashville, Tennessee
- Represents Federation of American Hospitals.
- Served as White House Fellow to Arthur Goldberg from 1966-1967.
- Served as a member of the 1982 Advisory Council on Social Security which studied medicare program.
- An employee of Hospital Affiliate when it was acquired by Hospital Corporation of America in 1981. Was then named Senior Vice President - Public Affairs.
- HCA, a proprietary company, owns and operates 176 hospitals in the US with a total of about 29,000 beds. In addition, they manage another 190 hospitals, with 24,000 beds. They are currently located throughout the country and are present in about 35-40 states.
Eunice Cole
President
American Nurses Association, Kansas City
- Currently serving her second term as President of the American Nurses Association.
- From 1974-1976 was President of the Washington State Nurses Association.
Dr. Judith Ryan
Executive Director
American Nurses Association, Kansas City
- From 1976-1980 Dr. Ryan served as Director of Nursing Education at the Rochester Methodist Hospital in Rochester, Minnesota.
- Dr. Ryan has been with the American Nurses Association since 1980 and has been executive director since 1982.
(entire page handwritten)
2
SNF/HH taking care of sicker pt's - increased demand for nsg.
<--> services in these settings
Sammons
Hopkins/AMA (illegible) quality study
Heyssel
house/stall - under increasing pressure - frozen levels of pay -
fewer admissions
intra system changing - greater pressures (down arrow) quality
Sammons
don't force reductions in (illegible)/financing too soon -
we need quality residents
Ryan
demand for home care in community -
doing study on acuity - (up arrow) demand for nsg
services and patient population shifts -
concerns: VNA etc. being challenged by (illegible) service home health agencies -
no coordination of care -
Cole
people falling through the cracks - particularly frail
elderly -
need to look at under(illegible) traditional agencies
Vohs
competition getting wild out there - surons quality concerns -
uncompensated care becomes greater concern because
of competition
Howard
25% fewer pt's - mostly reductions in private patients -
but now also have time for medicare
Los stable now after dropping
have laid off 6,500 personnel
- bad debts 2-3% higher
- rural hosp's - not likely to survive because of drq's
-3-
Jerome A. Crest
President and Administrator
Emanuel St. Joseph's Hospital, Mankato, Minnesota
- Represents American Hospital Association.
- Has been President and Administrator of Emanuel St. Joseph's Hospital since 1984.
- Recently completed 18 months service as chairman of the Minnesota Hospital Association.
- Emanuel St. Joseph's is a 260 bed hospital which provides a broad range of services.
Dr. Robert Heyssel
President
Johns Hopkins Hospital, Baltimore, Maryland
- Represents American Association of Medical Colleges, Council of Teaching Hospitals
- Named President in July 1983 after serving as Executive Vice President and Director since 1972.
- Is professor of Medicine at Johns Hopkins School of Medicine.
- Headed an Institute of Medicine Committee on controlling the supply of beds and a National Academy of Sicnes Committee regarding emergency medical services.
- Hopkins is a very large, 1069 bed, major teaching facility providing a broad range of services.
James A. Vohs
Chairman, President and CEO
Kaiser Foundation Health Plan
- Mr. Vohs has been with the Kaiser Foundation Health Plan since 1952.
- Kaiser has approximately 4.7 million enrollees nationwide. The organization is organized into 12 regions and is present in 15 states.
- Kaiser recently purchased an HMO in Kansas City which is affiliated with the University of Kansas Medical Center. They currently have about 9,300 enrollees.
(entire page handwritten)
hurig
(illegible)
recon
waiver
no fee freeze
Quayle
GME
FMG's -
maldrotib. of (illegible)'s primary care
Wilson
nsg. homes/qual.
pps - quality/aged
quality of care in military
concurrent/prospective quality ck - not retrospective
Hotchkiss
fee freeze/congress
breaking contract
don't like pal/non-pal - old mix
hatch/md's claiming they will request pt's
Hotchkiss - not wide spread - competition growing
Sammons
not widespread - but real concern re: access/accountability
drq's - counterproductive re: liability/quality - (up arrow) malpractice - cosponsor hatch
Hatch
malpractice = too much care as protection
Hurig
drq's create opportunity for malpractice
Sammons
we're sending them home sicker/quicker
Heyssel
- old don't like being sent home from ambulatory surgery - need to
loosen up on amb surg rules
- drq's don't measure what they are supposed to --
- people fall out of averages -
higher costs of teaching hospitals
14% educational costs
Ryan
impact on nsg - drq's don't look @ nsg resource use -
shorter length of stay reduces ability to
prepare pt's for home
HEALTH BREAKFAST ATTENDEES
Thursday, October 10, 8:00 a.m., Room S-230
(Coffee and Breakfast in S-207)
Dr. James H. Sammons
Executive Vice President
American Medical Association, Chicago, Illinois
- Chief Executive Officer for 10 1/2 years.
- Previously practiced family medicine in Texas for approximately 20 years.
Dr. William S. Hotchkiss
Chairman, Board of Trustees
American Medical Association, Chesapeake, Virginia
- Presently a thoracic surgeon in Chesapeake, Virginia.
- Currently a member of the attending staffs of the Leigh Memorial Hospital and Chesapeake General Hospital in Norfolk.
- Previously AMA Commissioner to the Joint Commission on the Accreditation of Hospitals before election to the Board of Trustees in 1978.
Virgil S. Edwards
Administrator
Redbud Community Hospital, Clearlake, CA
- Represents Public Hospital Association.
- Has been in the health care field for about 9 years.
- Before becoming Administrator of Redbud Community Hospital in 1984, was assistant administrator of a 398 bed hospital.
- Redbud, a 27 bed hospital located in a rural community, provides primarily medical surgical services.
- The hospital was involved in a major dispute with HHS last winter over the implementation of the DRG system and their payment levels. Part of their concerns involved the payment for services provided to the indigent.
-2-
Samuel H. Howard
Senior Vice President - Public Affairs
Hospital Corporation of America, Nashville, Tennessee
- Represents Federation of American Hospitals.
- Served as White House Fellow to Arthur Goldberg from 1966-1967.
- Served as a member of the 1982 Advisory Council on Social Security which studied medicare program.
- An employee of Hospital Affiliate when it was acquired by Hospital Corporation of America in 1981. Was then named Senior Vice President - Public Affairs.
- HCA, a proprietary company, owns and operates 176 hospitals in the US with a total of about 29,000 beds. In addition, they manage another 190 hospitals, with 24,000 beds. They are currently located throughout the country and are present in about 35-40 states.
Eunice Cole
President
American Nurses Association, Kansas City
- Currently serving her second term as President of the American Nurses Association.
- From 1974-1976 was President of the Washington State Nurses Association.
Dr. Judith Ryan
Executive Director
American Nurses Association, Kansas City
- From 1976-1980 Dr. Ryan served as Director of Nursing Education at the Rochester Methodist Hospital in Rochester, Minnesota.
- Dr. Ryan has been with the American Nurses Association since 1980 and has been executive director since 1982.
-3-
Jerome A. Crest
President and Administrator
Emanuel St. Joseph's Hospital, Mankato, Minnesota
- Represents American Hospital Association.
- Has been President and Administrator of Emanuel St. Joseph's Hospital since 1984.
- Recently completed 18 months service as chairman of the Minnesota Hospital Association.
- Emanuel St. Joseph's is a 260 bed hospital which provides a broad range of services.
Dr. Robert Heyssel
President
Johns Hopkins Hospital, Baltimore, Maryland
- Represents American Association of Medical Colleges, Council of Teaching Hospitals
- Named President in July 1983 after serving as Executive Vice President and Director since 1972.
- Is professor of Medicine at Johns Hopkins School of Medicine.
- Headed an Institute of Medicine Committee on controlling the supply of beds and a National Academy of Sicnes Committee regarding emergency medical services.
- Hopkins is a very large, 1069 bed, major teaching facility providing a broad range of services.
James A. Vohs
Chairman, President and CEO
Kaiser Foundation Health Plan
- Mr. Vohs has been with the Kaiser Foundation Health Plan since 1952.
- Kaiser has approximately 4.7 million enrollees nationwide. The organization is organized into 12 regions and is present in 15 states.
- Kaiser recently purchased an HMO in Kansas City which is affiliated with the University of Kansas Medical Center. They currently have about 9,300 enrollees.
UNITED STATES SENATE
OFFICE OF THE MAJORITY LEADER
WASHINGTON, DC
BOB DOLE
KANSAS
October 15, 1985
Dear Mrs. Cole:
Thank you for attending last Thursday's breakfast meeting here in Washington. I am sorry that I was delayed but enjoyed the opportunity to meet with you following your discussion with Senators Heinz, Quayle, Wilson, and Hatch.
I particularly appreciated your comments on the need to undergird our traditional home health agencies. These services have become increasingly important as we create incentives for beneficiaries to be discharged earlier, or simply remain at home, for the majority of their care.
Clearly also of concern is the care of those who "fall through the cracks" of traditional financing mechanisms. We will continue to seek out ways to care for these individuals without further adding to our deficit problems.
I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance.
Sincerely yours,
(signature)
Bob Dole
Mrs. Eunice Cole
President
American Nurses Association
2420 Pershing Road
Kansas City, Missouri 64108
UNITED STATES SENATE
OFFICE OF THE MAJORITY LEADER
WASHINGTON, DC
BOB DOLE
KANSAS
October 15, 1985
Dear Dr. Hotchkiss:
Thank you for your willingness to attend the breakfast meeting last week. I am sorry I was delayed and unable to join you but understand that the discussion was very useful.
I know you are particularly concerned with the continuation of the fee freeze and the participating physician program. Unfortunately, our continued battle to reduce the Federal deficit has again forced us to make a number of very difficult decisions. I can understand your frustration with what appears to be the breaking of an agreement with respect to the freeze, but you must also understand our dilemma with a projected deficit in excess of $170 billion.
Over the long term, I agree that together we must begin to seriously examine payment reform. We have a responsibility to both the medicare beneficiary and to the physicians nationwide who care for these patients, to
-2-
create a reasonable and equitable payment system.
I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance.
Sincerely yours,
(signature)
BOB DOLE
Majority Leader
Dr. William S. Hotchkiss
Chairman, Board of Trustees
American Medical Association
2147 Old Greenbriar Road
Chesapeake, Virginia 23320
UNITED STATES SENATE
OFFICE OF THE MAJORITY LEADER
WASHINGTON, DC
BOB DOLE
KANSAS
October 15, 1985
Dear Dr. Ryan:
Thank you for attending last Thursday's breakfast meeting here in Washington. I am sorry that I was delayed but enjoyed the opportunity to meet with you following your discussion with Senators Heinz, Quayle, Wilson, and Hatch.
I was particularly interested to learn of your ongoing survey of home health agencies and your intention of learning more about the acuity of the patient mix and the resulting nursing service needs. It has been clear to me for some time, particularly since the implementation of the Prospective Payment System, that attention needed to be given to both home health care service providers and nursing home service providers. It may well be time to reexamine the design and financing of these benefits. Patient care needs seemed to have changed as has our capacity to care for people in non-institutional settings. As we continue to urge reductions in the use
-2-
of inpatient services, we must make an effort to assure that quality, alternative services are readily available.
I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance.
Sincerely yours,
(signature)
BOB DOLE
Majority Leader
Dr. Judith Ryan
Executive Director
American Nurses Association
2420 Pershing Road
Kansas City, Missouri 64108
UNITED STATES SENATE
OFFICE OF THE MAJORITY LEADER
WASHINGTON, DC
BOB DOLE
KANSAS
October 15, 1985
Dear Jim:
Thank you for attending last Thursday's breakfast meeting here in Washington. I am sorry that I was delayed but enjoyed the opportunity to meet with you following your discussion with Senators Heinz, Quayle, Wilson, and Hatch.
I particularly appreciated your comments regarding the need to keep a close eye on the quality of the health care services provided to the elderly. As you point out, this is especially true with respect to certain prepaid health plans. We cannot afford a repeat of the problems documented in California in the 1970's.
Of course, on the non-HMO side, we must be equally as vigilant. The Prospective Payment System has achieved a great deal in bringing about reductions in cost and lengths of stay, but neither of these
-2-
achievements can overcome serious quality of care issues should they occur.
I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance.
Sincerely yours,
(signature)
BOB DOLE
Majority Leader
James A. Vohs
Chairman, President, and Chief Executive Officer
Kaiser Foundation Health Plan
The Ordway Building
One Kaiser Plaza
Oakland, California 94612
UNITED STATES SENATE
OFFICE OF THE MAJORITY LEADER
WASHINGTON, DC
BOB DOLE
KANSAS
October 15, 1985
Dear Mr. Edwards:
Thank you for attending last Thursday's breakfast meeting here in Washington. I am sorry that I was delayed but enjoyed the opportunity to meet with you following your discussion with Senators Heinz, Quayle, Wilson, and Hatch.
I particularly appreciated hearing your concerns about the survival of small rural hospitals and the need of certain institutions for continued access to tax exempt bonds.
With respect to rural hospitals, it was clear from the outset of the Prospective Payment System that we might well need to make adjustments. As you know, the Department was directed to prepare a study on the need to make adjustments for small rural hospitals; the results are not due for some months however. In the interim, I would be very interested in your thoughts on how best to isolate some of the legitimate needs of these institutions and address them.
With respect to tax exempt bonds, as I indicated in our discussion, it appears unlikely that the tax reform bill will see
-2-
action in the Senate this year. However, in anticipation of these discussions, I will review carefully the current use of this authority and its value to non-profit institutions like your own.
I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance.
Sincerely yours,
(signature)
BOB DOLE
Majority Leader
Virgil S. Edwards
Administrator
Redbud Community Hospital
Redbud Hospital District
Clearlake, California 95422
UNITED STATES SENATE
OFFICE OF THE MAJORITY LEADER
WASHINGTON, DC
BOB DOLE
KANSAS
October 15, 1985
Dear Mr. Crest:
Thank you for attending last Thursday's breakfast meeting here in Washington. I am sorry that I was delayed but enjoyed the opportunity to meet with you following your discussion with Senators Heinz, Quayle, Wilson, and Hatch.
I particularly appreciated hearing your concerns about the survival of small rural hospitals. It was clear from the outset of the Prospective Payment System that we might well need to make a limited number of adjustments to meet certain specific needs. To assist us, as you know, the Department was directed to prepare a study on the needs of small rural hospitals; the results are not due for some months however. In the interim, I would be very interested in your thoughts on how best to isolate some of the legitimate needs of these institutions and address them.
I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance.
Sincerely yours,
(signature)
BOB DOLE
Majority Leader
Jerome A. Crest
President and Administrator
Emanuel St. Joseph's Hospital
325 Garden Boulevard
Mankato, Minnesota 56001
UNITED STATES SENATE
OFFICE OF THE MAJORITY LEADER
WASHINGTON, DC
BOB DOLE
KANSAS
October 15, 1985
Dear Dr. Heyssel:
Thank you for attending last Thursday's breakfast meeting here in Washington. I am sorry that I was delayed but enjoyed the opportunity to meet with you following your discussion with Senators Heinz, Quayle, Wilson, and Hatch.
I particularly appreciated your comments on the need to find a method of financing care for those without access to any financial support. As I mentioned, considerable time was spent on a bill last year which dealt with the insurance needs of the unemployed. Though we were unable to secure passage at that time, we may be well served by a review of that initiative once again. However, as you pointed out, the problem is not simply a Federal issue, but rather one that needs the attention of all.
I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance.
Sincerely yours,
(signature)
BOB DOLE
Majority Leader
Dr. Robert Heyssel
President
Johns Hopkins Hospital
600 North Wolfe
Baltimore, Maryland 21205
UNITED STATES SENATE
OFFICE OF THE MAJORITY LEADER
WASHINGTON, DC
BOB DOLE
KANSAS
October 15, 1985
Dear Jim:
Thanks for taking the time to attend last week's breakfast meeting. Unfortunately, I was unavoidably delayed and missed getting the chance to talk with you, however, I understand the discussion went quite well.
Like you, I am concerned that as we continue to try to bring health care costs under control, we keep a close eye on the quality of care being provided to medicare beneficiaries nationwide. I urge you to let me know if you have any particular concerns that we should address at this time and look forward to seeing you in the near future.
Sincerely yours,
(signature)
BOB DOLE
Majority Leader
Dr. James H. Sammons
Executive Vice President
American Medical Association
535 N. Dearborn
Chicago, Illinois 60610
UNITED STATES SENATE
OFFICE OF THE MAJORITY LEADER
WASHINGTON, DC
BOB DOLE
KANSAS
October 15, 1985
Dear Sam:
Thank you for attending last Thursday's breakfast meeting here in Washington. I am sorry that I was delayed but enjoyed the opportunity to meet with you following your discussion with Senators Heinz, Quayle, Wilson, and Hatch.
I particularly appreciated your comments on the need to find a method of financing care for those without access to any financial support. As I mentioned, considerable time was spent on a bill last year which dealt with the insurance needs of the unemployed. Though we were unable to secure passage at that time, we may be well served by a review of that initiative once again. However, as you pointed out, the problem is not simply a Federal issue, but rather one that needs the attention of all.
I do hope you will continue to keep me apprised of your concerns and ask that you call upon me if I can be of any assistance.
Sincerely yours,
(signature)
BOB DOLE
Majority Leader
Samuel H. Howard
Senior Vice President - Public Affairs
Hospital Corporation of America
1 Park Plaza
Nashville, Tennessee 37202
HEALTH BREAKFAST ATTENDEES
Thursday, October 10, 8:00 a.m., Room S-230 (handwritten: Hotchkiss)
(Coffee and Breakfast in S-207)
handwritten in top margins: Chall, (illegible), Dole, Vohs, Wils, Edward, Heinz, Cole, Hatch, Heyssel, Quayle
Senator Dole
Senator Hatch
Senator Heinz
Senator Wilson (check mark)
Senator Quayle (check mark)
Sheila Burke
Dr. James H. Sammons
Executive Vice President
American Medical Association
535 N. Dearborn
Chicago, Illinois 60610
(312) 645-4302
Virgil S. Edwards
Administrator
Redbud Community Hospital
Redbud Hospital District
Clearlake, California
(707) 994-6486
Eunice Cole, President
American Nurses Association
2420 Pershing Road
Kansas City, Missouri 64108
(816) 474-5720
Jerome A. Crest, President and Administrator
Emanuel St. Joseph's Hospital
325 Garden Boulevard
Mankato, Minnesota 56001
James A. Vohs
Chairman, President and Chief Executive Officer
Kaiser Foundation Health Plan
The Ordway Building
One Kaiser Plaza
Oakland, California 94612
(415) 271-5910
Dr. William S. Hotchkiss
Chairman, Board of Trustees
American Medical Association
2147 Old Greenbriar Road
Chesapeake, Virginia 23320
Samuel H. Howard
Senior Vice President - Public Affairs
Hospital Corporation of America
1 Park Plaza
Nashville, Tennessee 37202
(615) 327-9551
Judith Ryan, Executive Director
American Nurses Association
2420 Pershing Road
Kansas City, Missouri 64108
(816) 474-5720
Dr. Robert Heyssel
President
Johns Hopkins Hospital
600 North Wolfe
Baltimore, Maryland 21205
(301) 955-5667
only note on page (handwritten): Thursday; 3; dole
TENTATIVE
HEALTH BREAKFAST ATTENDEES
Thursday, October 10, 8:00 a.m., Room S-230
(Coffee and Breakfast in S-207)
handwritten at top of page: Packwood, Chafee
Senator Dole (handwritten: confirmed)
Senator Durenberger (handwritten: ?)
Senator Hatch (handwritten: Cindy - 135 Russell)
Senator Heinz (handwritten: confirmed)
Senator Chafee (crossed out)
Senator Wilson (handwritten: Dottie w/c/b)
Senator Quayle (handwritten: Cynthia w/c/b - SH - 524)
Sheila Burke (handwritten: confirmed)
Dr. James H. Sammons (handwritten: MD, confirmed)
Executive Vice President
American Medical Association
535 N. Dearborn
Chicago, Illinois 60610
(312) 645-4302
Virgil S. Edwards (handwritten: confirmed)
Administrator
Redbud Community Hospital
Redbud Hospital District
Clearlake, California
(707) 994-6486
Eunice Cole, President (handwritten: conf.)
American Nurses Association
2420 Pershing Road
Kansas City, Missouri 64108
(816) 474-5720
Jerome A. Crest, Administrator (handwritten: conf.)
Emanuel St. Joseph's Hospital
325 Garden Boulevard
Mankato, Minnesota 56001
James A. Vohs (handwritten: conf.)
Chairman, President and Chief Executive Officer
Kaiser Foundation Health Plan
The Ordway Building
One Kaiser Plaza
Oakland, California 94612
(415) 271-5910
handwritten note: 1:15-9:15 tonight, Sheraton Grand
William H. Hotchkiss, MD (handwritten: confirmed)
Chairman, Board of Trustees
American Medical Association
2147 Old Greenbriar Road
Chesapeake, Virginia 23320
Samuel H. Howard (handwritten: conf.)
Senior Vice President - Public Affairs
Hospital Corporation of America
1 Park Plaza
Nashville, Tennessee 37202
(615) 327-9551
Judith Ryan, Executive Director (handwritten: conf.)
American Nurses Association
2420 Pershing Road
Kansas City, Missouri 64108
(816) 474-5720
Dr. Robert Heyssel (handwritten: conf.)
President
Johns Hopkins Hospital
600 North Wolfe
Baltimore, Maryland 21205
(301) 955-5667
TENTATIVE (outlined)
HEALTH BREAKFAST ATTENDEES
Thursday, October 10, 8:00 a.m., Room S-230
Senator Dole (check mark)
Senator Durenberger (check mark)
Senator Hatch (check mark, handwritten: confirmed)
Senator Heinz - confirmed (check mark, handwritten: confirmed)
Senator Chafee - confirmed (check mark)
Senator Wilson (check mark), handwritten: confirmed
Senator Quayle (check mark), handwritten: confirmed
Sheila Burke (check mark)
Dr. James H. Sammons (check mark)
Executive Vice President
American Medical Association
535 N. Dearborn
Chicago, Illinois 60610
(312) 645-4302
Virgil S. Edwards (handwritten: confirmed), (check mark)
Administrator
Redbud Community Hospital
Redbud Hospital District
Clearlake, California
(707) 994-6486
(Contact: Larry Gage 293-8960)
Eunice Cole, President (check mark)
Judith Ryan, Executive Director (check mark)
American Nurses Association
2420 Pershing Road
Kansas City, Missouri 64108
816-474-5720
Jerome A. Crest, Administrator (check mark)
Emanuel St. Joseph's Hospital
325 Garden Boulevard
Mankato, Minnesota 56001
(Contact: Jack Owen (AHA 638-1100)
James A. Vohs (check mark)
Chairman, President and Chief Executive Officer
Kaiser Foundation Health Plan
The Ordway Building
One Kaiser Plaza
Oakland, California 94612
(415) 271-5910
Senator Packwood not coming
William S. Hotchkiss, M.D. (check mark)
Chairman, Board of Trustees
American Medical Association
2147 Old Greenbriar Road
Chesapeake, Virginia 23320
handwritten notes:
Sam (illegible)
Howard
Senior VP Public Affairs
Hospital Corp of America
1 Park Plaza
Nashville, Tennessee 37202
615-327-9551
Pres Elect of Federation
Pres Cmte on SS.
S-2017
17
-2-
(Contact: Richard Froh 296-1314)
Dr. Robert Heyssel
President
Johns Hopkins Hospital
600 North Wolfe
Baltimore, Maryland 21205
(301) 955-5667
TENTATIVE
HEALTH BREAKFAST ATTENDEES
Thursday, October 10, 8:00 a.m., Room S-230
Senator Dole (handwritten: OK)
Senator Durenberger
Senator Hatch
Senator Packwood (handwritten: no)
Senator Heinz (handwritten: OK)
Senator Chafee (handwritten: OK)
Senator Wilson
Senator Quayle
Sheila Burke
Dr. James H. Sammons
Executive Vice President
American Medical Association
535 N. Dearborn
Chicago, Illinois 60610
(312) 645-4302
Mike Bromberg's person (833-3090)
(David Jones, Humana?) (handwritten: not invited)
Virgil S. Edwards
Administrator
Redbud Community Hospital
Redbud Hospital District
Clearlake, California
(707) 994-6486
(Contact: Larry Gage 293-8960
Eunice Cole, President
Judith Ryan, Executive Director
American Nurses Association
2420 Pershing Road
Kansas City, Missouri 64108
816-474-5720
American Hospital Association
(Contact: Jack Owen 638-1100) (crossed out and replaced with Jerome A. Crest Administrator)
James A. Vohs
Chairman, President and Chief Executive Officer
Kaiser Foundation Health Plan
The Ordway Building
One Kaiser Plaza
Oakland, California 94612
handwritten note on page:
Wm S. Hotchkiss MD
Chairman
AMA
Bd. of Trustees
2147 Old Greenbriar Rd
Chesapeake VA 23320
-2-
(415) 271-5910
(Contact: Richard Froh 296-1314)
Dr. Robert Heyssel
President
Johns Hopkins Hospital
600 North Wolfe
Baltimore, Maryland 21205
(301) 955-5667
MEMORANDUM OF CALL
TO: (handwritten) Joyce
YOU WERE CALLED BY (checked)
YOU WERE VISITED BY
(handwritten: Jim Doherty
OF (Organization) 6381100
PLEASE CALL (checked) --> PHONE NO. CODE/EXT.
WILL CALL AGAIN
RETURNED YOUR CALL
IS WAITING TO SEE YOU
WISHES AN APPOINTMENT
MESSAGE (handwritten)
Am Hosp. Assoc.
H: breakfast Thurs.
RECEIVED BY (handwritten) KMR
DATE (handwritten) 10/3
TIME (handwritten) 4:00
MEMORANDUM OF CALL
TO: (handwritten) S. Burke
YOU WERE CALLED BY
YOU WERE VISITED BY
(handwritten) Deborah Knight
OF (organization) (handwritten) Dr. Heyssel
PLEASE CALL --> PHONE NO. CODE/EXT.
WILL CALL AGAIN
RETURNED YOUR CALL
IS WAITING TO SEE YOU
WISHES AN APPOINTMENT
MESSAGE (handwritten)
301-555-5667
re: breakfast
oct. 10
RECEIVED BY (handwritten) P
DATE (handwritten) 10-4
TIME (handwritten) 9:15
handwritten: tentative
HEALTH BREAKFAST ATTENDEES
Thursday, October 10, 8:00 a.m., Room S-230
Dr. James H. Sammons (handwritten: bringing someone)
Executive Vice President
American Medical Association
535 N. Dearborn
Chicago, Illinois 60610
(312) 645-4302
Mike Bromberg's person (833-3090)
(David Jones, Humana?)
Virgil S. Edwards
Administrator
Redbud Community Hospital
Redbud Hospital District
Clearlake, California
(707) 994-6486
(Contact: Larry Gage 293-8960)
Eunice Cole (handwritten: and Ryan)
President
American Nurses Association
(Contact: Judith Ryan, Executive Director 816-474-5720)
American Hospital Association
(Contact: Jack Owen 638-1100) (handwritten: (illegible) Doherty)
James A. Vohs
Chairman, President and Chief Executive Officer
Kaiser Foundation Health Plan
The Ordway Building
One Kaiser Plaza
Oakland, California 94612
(415) 271-5910
(Contact: Richard Froh 296-1314)
Dr. Robert Heyssel
President
Johns Hopkins Hospital
600 North Wolfe
Baltimore, Maryland 21205
(301) 955-5667
handwritten: Debra Knight
handwritten notes:
Dole
Durenberger
Hatch ?
Sheila Burke
Jerry Crest Administrator
Emanual St. Joseph's Hosp in Minn.
325 Garden Blv
Mankato, Minn
Jerome A. Crest 56001
Entire next page handwritten
ARMSTRONG
tony coppolino
Thursday 8:00 am
Oct 10, 1985
HEALTH BREAKFAST
- Jim Sammon MD (312) 645-4302
- AMA Board Member
Dr. James H. Sammons
Exec V.P.
AMA 5335 N. Dearborn
Chic. IL 60610
- David Jones (alex) - Humana (CONTACT MIKE BROMBERG 833-3090)
Virgil S. Edwards RH District
- Administrator Redbud Hosp (community)
Redbud, Cal. Clearlake CA 707-994-6486
contact/Larry Gage 293-8960
- American nurses drsn.
Judith Ryan
Executive Director (816) 474-5720
Eunice Cole - president
- American Hospital Assn. - CONTACT Jack Owen 638-1100
- Kaiser Foundation Health Plan
James A. Vohs Chairman, President CEO
contact: Richard Froh
Kaiser Fdtn Health Plan
The Ordway Bldg.
One Kaiser Plaza
Oakland, CA 94612
415 271-5910
- AAMC Heyssel contact Dick Knapp 828-0490
(handwritten notes at top of page)
- Judith Ryan
Executive Director
American Nurses Association
- Pam Maraldo
Executive Director
National League for Nursing
- NSQ
- Public
- Teaching
OCT 8
8 am
(illegible) home health
Cigna?
Petrocelle
Robert Van Tuyle (labeled 2, nsg hornes
Chairman
Beverly Enterprises
873 So. Fairoaks Avenue
Pasadena, California 91005
213-684-1100
Karl Bays (labeled 4)
Chairman & CEO
American Hospital Supply Corp.
One American Plaza
Evanston, Illinois 60201
312-866-4000
(bought by Baxter-Travenol not sure what his title will be)
Thomas Frist, Jr. M.D. (crossed out)
President & CEO
Hospital Corporation of America
P.O. Box 550
Nashville, Tennessee 37203
615-327-9551
Walter Weisman (crossed out)
President & Chief Operating Officer
American Medical International
414 No. Camden Drive
Beverly Hills, California 90210
213-278-6200
Charles Ewell, Ph. D. (crossed out)
President
American Health Care Systems
1205 Prospect, Suite 520
La Jolla, California 92073
Richard Knapp
Assoc. of American Medical Colleges
One Dupont Circle, N.W.
Washington, D.C. 20035
828-0400
Don L. Arnwine
President
Volunteer Hospitals of America
P.O. Box 160
Erving, Texas 75016
214-830-0000
Lewis W. Lehr (labeled 5)
Chairman & CEO
3 M Co.
3 M Center
St. Paul, Minnesota 55144
David A. Jones (labeled 1)
Chairman & CEO
Humana Inc.
P.O. Box 1438
Louisville, KY 40201
502-580-1000
Richard K. Eamer (crossed out)
Chairman & CEO
National Medical Enterprises
11620 Wilshire Blvd.
Los Angeles, California 90025
213-479-5526
Michael D. Bromberg
Executive Director
Federal of American Hospitals
1111 19th Street, N.W.
Washington, D.C. 20036
Robert A. Schoellhorn (labeled 3)
Chairman & CEO
Abbott Laboratories
Abbott Park
North Chicago, Illinois 60064
312-937-6100
notes on bottom of page:
non
prof
chain
Wagmeller
MD's
pharm (circled)
next page handwritten: ABBOTT LABS 659-8524
American Hospital Supply Corporation
1090 Vermont Avenue N.W.
Suite 210
Washington DC 20005
Telephone 202 842-3445
September 25, 1985
Ms. Sheila P. Burke
Deputy Chief of Staff
Office of the Majority Leader of the Senate
S-230 Capitol Building
Washington, D.C. 20510
Dear Sheila:
It was good talking to you last week. Karl Bays is very interested in meeting with the Majority Leader on health issues.
Mr. Bays will be out of the country for part of the week of October 7th. He will be in Washington for an Institute of Medicine meeting on October 17th and is expected to arrive in the evening on the 16th.
He is also addressing the Health Industry Manufacturers' Association on October 3rd at noon. If that date is conceivable, I could ask him to leave Chicago at 4:30 a.m. to make a breakfast meeting with the Senator.
October 17th in the morning looks like the optimal date for Mr. Bays. I know the Senator's schedule is incredibly intense and that day may not be appropriate. I do not know who the other prospective invitees are, but the Institute of Medicine meeting on the 17th draws a number of health industry leaders. I will try any other date but these look like the best so far.
On the other matter that we discussed, I would like to ask you for a few minutes of your time with Karl and me. Please give me a call on either matter at your convenience.
Best regards,
(signature)
David J. Aho, Esq.
Director Government Relations
BOB DOLE
KANSAS
United States Senate
OFFICE OF MAJORITY LEADER
S-230 THE CAPITOL
(entire page handwritten)
son
rural
sole comm.
son rural
admin. of redbud
Rn Anderson
Parkland Hosp.
Texas
entire page handwritten:
HEALTH BREAKFAST #1
- Hospital Industry
- Physicians
- Nurses
- HMO's
HEALTH BREAKFAST #2
- Pharmaceuticals
- Nursing homes
- Hospital supply/manufacturing
handwritten letter:
Sheila
Dick Knapp said that Bob Heyssel may be in Philadelphia (crossed out and replaced with Princeton) the morning of Oct 10th - if date of breakfast changes - Heyssel would like to be there.
Back up names if 10th is firm
J Robert Buchanon MD
(illegible) Mass Gen
(617) 726-2100
C. Thomas Smith
President
Yale New Haven Hospital
(203) 785-2611
entire page handwritten:
HEALTH MEETING #1
HOSPITALS -- DAVID JONES/HUMANA
MD's -- Jim Sammons, one other
Nurses
HEALTH MTG. #2
- PHARM -- ABBOTT
- Hosp supply -- DM Hosp Supply, SM
- NSG Homes -- Robert Van Tuyle
- Home Health
- HMO's -- CIGNA, Kaisser
entire page handwritten:
HOSPITALS -
AHA
A Pub Hosp -- Redbud, Parkland
AAMC --> Hopkins --> Heyssel
OOT10 Press 301-955-5667
Johns Hopkins Hosp.
FAH -- David Jones, Humana
Nurses
Physicians
Position: 2400 (6 views)