- A new 453-page book by journalist Steven Brill released last week, "America's Bitter Pill," shines a big spotlight on the $11-billion University of Pittsburgh Medical Center health system and its president and CEO Jeffrey Romoff, in particular.
- The book makes several mentions of UPMC as an example of "how nonprofit hospitals had become hard-charging big businesses" as it details how UPMC and Highmark, the area's leading insurer, have dominated the region's healthcare.
- In the book, Brill discusses how UPMC "bought up area hospitals to create a massive provider network while launching its own health insurance plan to compete with Highmark," according to reports. Brill quotes Romoff as referring the acquisitions as "just a step-by-step process of controlling the impediments."
Brill's Time magazine article on hospital bills and how they're killing us was one of the most talked-about pieces of journalism ever penned about the healthcare industry (and taught millions of Americans terms like "chargemaster" as well as exposing inconsistent hospital billing policies). But while Brill refers to UPMC as "perhaps the world's most tough-minded, profit-oriented nonprofit," the increased scrutiny on healthcare alliances turning into monopolies is national.
Brill suggests bumping up regulations on non-profits to ensure they are "earning" their tax exemptions (not a new idea). Two of his suggestions include requiring at least two provider-insurer health systems in each market and capping operating profits at 8%. Brill also recommends putting a cap on CEO compensation at 60 times the lowest-paid physician. This is a common argument: Some advocates argue that the huge compensation packages of non-profit CEOs are out of sync with the ethos of the non-profit model; hospitals argue that such enormous paychecks are required to recruit adequate talent to the role.