Know- good news ...Middletown

swohio75 wrote: https://citymanagermiddletown.com/2017/10/17/kettering-health-network-rezoning-request/

Because we were directed to a supporting site concerning Kettering, and, having read the explanation, does not make it so as told by the city manager. With the lack of truthful, open, honest communication from this city government, it makes it extremely difficult to know what is correct. We are a forum of doubters and for good reason. We do not necessarily believe what is told to us by city hall. We are not that gullible. Some will throw themselves on the sword for the city leaders and believe anything they are told. Most of us are not that foolish.

I still do not know why the city leaders didn't welcome Kettering with open arms unless they were intimidated by Atrium's medical influence in town. Good paying jobs. Possibility of some quality people locating to Middletown instead of the rubbish we seem to attract. The creation of a competitive medical choice situation for the people of this city. The addition of another medical facility along the Union Rd. corridor. A possibility of Kettering Medical offering more diversity for medical procedures, testing and outpatient services. A possibility of people who have insurance that Atrium won't take receiving medical services from Kettering instead, and, of course, the great benefit of more medical facilities close to home that will be used in greater numbers by an aging Baby Boomer population.

No reason what so ever to have denied any Kettering Medical facility proposal IMO. Another blown opportunity by this so-called "business friendly" city. When they can demonstrate just how friendly this town can be, they screw that up too. Seems to me that everything the city building touches, they screw up. Sad to see.   

Has anyone noticed that the entire Atrium/ Kettering matter has ABSOLUTELY NO MENTION AT ALL in the 10/17/17 Journal-News after Kettering abandoned their zoning request yesterday afternoon? (The reason for that might be very interesting!)  Maybe Kettering will be making other plans for a hospital at a nearby location along or near I-75 close to Middletown.  In that case, Atrium and the city of Middletown will be vulnerable to their competition and will probably lose more of the healthcare market share and tax revenue.

Mayor Larry Mulligan deserves major credit for loosing this and other opportunities to improve Middletown’s dire social-economic condition. Mulligan, under the “guidance” of city manager, Doug Adkins, has too often used our taxpayer’s money to the city’s detriment.

A change in leadership on city council will be required in order to attain a fair and honest local government which will represent all of Middletown instead of a select few. If no resignation(s?) is forthcoming, then the time may be ripe for a recall petition. This change, if successful, ought to be followed with the selection of a new city manger who will hold the city’s best interest above his own.

Unless a majority of Middletown’s taxpaying voters come out in support of making necessary changes in our city government, we will suffer many more years of abuse.

Oooops!  How could I possibly have forgotten to include the Manchester Inn plus the Snider Building to this list of potential projects?  

whistlersmom wrote: Next, they claim that when Atrium was built, there was a need for “expansion” (larger capacity?) of the hospital. The whole truth is … the old Middletown Hospital which Atrium replaced had about twice the number of beds in the new section (and probably 4 times the number of beds if you include the old section of the Middletown Hospital). Thus the expansion was actually a downsizing. And the new hospital proudly promised there would be 1000 new jobs … but the truth is they eliminated 1000 jobs. Now they are contradicting their original claim to need an expanded hospital by claiming that our city is not large enough to support a second hospital. Can’t have it both ways!!!

The Sunday, 10/15/17, Journal News has a new full page ad opposing the zoning change for Kettering Medical. It contains a list of supporters who are mainly doctors and others who are directly dependent on Atrium for a lively hood. In total they are a very small elite group making a desperate attempt to keep Kettering from providing the rest of Middletown’s citizens with an affordable, full service hospital.

We need people to speak up in support of the Kettering Medical Facility rezoning during the Public Hearing at the Council Meeting on Tuesday 10/17/17. This is very important to Middletown if you want a hospital that will accept your insurance and serve your healthcare needs!!!

The “endorsement ad” makes some statements which neglect to tell the “whole truth” on several points and even seems to twist the facts to suit their purpose.

First they claim that the new hospital “stood with Middletown and stayed local.” The truth is … Atrium originally wanted to build out of town, and would have, except Middletown gave Atrium the land east of I75 and sold $195 million in bonds to build the hospital here. After all this generosity, Atrium refused to retain the name, Middletown Hospital, and required that the old hospital be demolished as part of the “deal.” The city of Middletown provided all the infrastructure (water, sewer, storm water sewer and roadway) all free of charge as a bribe to keep the new hospital in Middletown. Kettering Medical is asking for NO FAVORS, NO MONEY and NO HELP from Middletown. Instead they want to CONTRIBUTE TO Middletown … jobs and a full service hospital recognized by major insurance companies.

Next, they claim that when Atrium was built, there was a need for “expansion” (larger capacity?) of the hospital. The whole truth is … the old Middletown Hospital which Atrium replaced had about twice the number of beds in the new section (and probably 4 times the number of beds if you include the old section of the Middletown Hospital). Thus the expansion was actually a downsizing. And the new hospital proudly promised there would be 1000 new jobs … but the truth is they eliminated 1000 jobs. Now they are contradicting their original claim to need an expanded hospital by claiming that our city is not large enough to support a second hospital. Can’t have it both ways!!!

Next, they claim that Atrium supports local schools, but in truth those local schools receiving Atrium’s support are Franklin/Warren County schools, and NOT Middletown/Butler County schools!!!! The city of Middletown has to pay Franklin school district for the loss of property taxes due to Atrium’s non-profit status. Remember the big fight with Franklin school district about Middletown trying to force students in the area surrounding Atrium north east of the Rte122 and I-75 intersection? The state of Ohio settled that in favor of Franklin and labeled Middletown’s action an attempted money grab.

Atrium, will soon, no longer have an agreement with United Healthcare (and perhaps Anthem) and may not even be in negotiations to come to an agreement. Additionally, United Healthcare has questioned the quality of care and the high prices charged at Atrium. They have sent letters to their insured, advising them to seek new doctors associated with a hospital other than Atrium.

Before being admitted at Atrium, patients whose insurance may not be accepted there, are asked to sign a form stating that they will be personally responsible for paying Atrium’s high priced bill (which also makes the patient responsible for any charges that are over and above what their insurance might pay). Some of those patients could easily be bankrupt by a potentially expensive hospital stay … which could cost $100,000 or so. Seems a bit like extortion.

There are multiple reasons why Atrium has mostly empty beds (poor quality care and high prices, the major ones) and that’s a result of their own short sighted, self-serving mismanagement. Atrium beds are empty because Middletown citizens have found it necessary to go out of town to seek quality care under their insurance plans. They are actually unable to use Atrium. This is the very reason that we need Kettering’s “new beds” that Atrium is so desperate to turn away.

How can Council, in good conscience, justify turning down the zoning change for Kettering?

I have no inside understanding of hour Council or Adkins feels on the subject

lol--I have no sources whatsoever on Council or in Admin

As I said, staff's recommendation was for approval.  Assumption is that the City's Planner ran this recommendation up through the chain of command (to Adkins likely) who didn't see an issue with the recommendation.  

thanx--good to know
so--shouldn't the emphasis be on whatever provides the most people in the area the most affordable and varied health care options possible during this time of uncertainty?
especially the way that Premiere is trending?
don't see a serious issue to re-zone an adjacent parcel to match, considering the services provided

and for the downtowners and junkies this weekend:

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This is a very interesting and controversial situation.

How can Council/Admin deny Kettering to do what the area was designed to be? Was Atrium promised exclusive along with free property?
They continue to deny health coverage to a large % of necessary plans, so shouldn't the citizens be protected by another similar service that actually accepts their health coverage? Won't this make both entities compete for clients by lowering health costs/rates??

Help me out here swohio!

The front page Journal News article on October 8,2017, regarding “Healthcare Costs” deserves close scrutiny! Here are some excerpts in black followed by comments in red.

Unless a deal is reached soon between UnitedHealthcare and Premier Health, thousands of people with Medicare plans through the insurer will soon have to decide whether they want to switch insurance companies or health care providers next year.

Does council really think that Atrium will win this battle opposing the largest healthcare insurers in the U.S.? Does council understand that Atrium’s services are overpriced and under performing?

That leaves many Medicare recipients with a dilemma. Medicare open enrollment period starts Oct. 15. and runs until Dec. 7. With the two parties saying their negotiations remain far apart, the 4,000 Medicare Advantage members with UnitedHealthcare that use Premier Health are faced with choosing a new doctor or a new insurance company.

You can get a new doctor affiliated with a competent (and less expensive) hospital and keep good insurance or go to Atrium Hospital and ? insurance (which will not be United Healthcare or Anthem since both have unsolved problems with Premier).

The dispute centers around the giant insurer’s plan to rank hospitals and doctors in tiers based on cost and quality, with the goal of incentivizing lower health care costs.

Premier opposes the ranking system, which it says is already steering patients away from its hospitals and providers.

“Our bottom line is off millions per month by this,” Duncan said.

Premier (Atrium) opposes being ranked by cost and quality! Isn’t that a surprise? Does Atrium really think losing United Healthcare patients (especially the large number of patients who are insured under medicare) would help their bottom line?

Although early data indicates that about 45 percent of the ER volume it normally gets from UnitedHealthcare-covered patients is staying with them, the remaining 55 percent appears to be going to other providers, he said.

Patients with health benefit plans that are part of the UnitedHealthcare tiering system have lower co-payments if they choose doctors from a group ranked “tier 1,” which includes physicians the insurer considers cost-efficient.

Premier officials say the ranking system doesn’t take into account expenses the hospital system has for offering specialized care such as its Level 1 trauma center, high-risk maternity care, and burn care. The cost data used by UnitedHealthcare to determine its tiers is skewed by these higher-end services, according to Premier.

Isn’t cost-efficient care described as the best care for the money? Atrium isn’t a Level 1 trauma center, it is a Level 3, the lowest trauma level in this area (look it up on the current rankings on the web). Can you explain how United Healthcare’s use of cost and quality to determine its tiers is at all unfair to Premier (Atrium)? They are just dealing with the facts!

“All of Premier’s proposals maintain its position as one of the most expensive health systems in Ohio while also demanding local businesses be restricted from offering competitive benefits that put consumer choice first and allow workers to be rewarded for choosing quality, cost-efficient care providers,” it stated.

Is Middletown’s council going to allow Premier (Atrium) to continue without any competition? Is council, once again, going to support their buddies to the detriment of the citizens of Middletown, by limiting the citizens to high cost and poor quality healthcare?

Premier officials dispute the data used by United-Healthcare, calling it “incomplete and misleading.” They also say it doesn’t account for the unique services that Premier provides and the high number of Medicaid patients that it treats at a financial loss to the health provider.

Medicaid does not pay the full cost of care, it says, so the system must either absorb a $50 million loss on its books or cost-shift from elsewhere to cover the difference.

“It’s our high-priced, high-cost, very specialized services that are driving our prices up,” said Duncan.

Does Premier (Atrium) think that they are the only hospital serving Medicaid patients? Isn’t Mr. Duncan, Premier’s chief financial officer, right when he says “It’s our high-priced, high-cost, … services that are driving our prices up?

In one example that Duncan described as a typical visit, a UnitedHealthcare patient arrived at the emergency room and received a $4,000 bill. Withholding the name of the patient, he said UnitedHealthcare designated the full bill to the patient.

From May, when the contract expired, to August, Premier saw roughly 1,100 similar UnitedHealthcare emergency room cases, Duncan said.

Do the ‘unique services’ that Atrium touts include billing a United Healthcare patient $4000 for an emergency room visit? The statement Atrium made here, about this patient, doesn’t tell whether they left with or without having received any services. If memory serves, this patient’s experience was reported as NOT receiving services but was charged for ‘arriving’ in (being admitted to?) the emergency room. Mr Duncan described this as a ‘typical’ visit to Atrium’s emergency room!!! and he said there were 1100 similar emergency room cases!!! IF all of those cases were charged $4000 that would be $4,400,000 … a lot of money for NOT performing any services IF all 1100 were like Mr Duncan’s ‘typical’ example.

Premier CEO Mary Boosalis said “from a pure humanitarian point of view,” she’d like to forgive the patients’ bills because they are stuck in the middle of something they can’t control. But, she said, that would be a slippery slope that would not only be prohibitively expensive, but also eventually lead to insurers like UnitedHealthcare and Anthem not being motivated to negotiate with Premier.

Does it really sound like Premier is motivated to negotiate with United Healthcare and Anthem ? And vice versa! Atrium has created it’s own untenable slippery slope for which they will try to blame everyone except themselves. The patients will bear the brunt of high costs if Atrium can successfully stick it to them. Don’t see anything ‘humanitarian’ about that!

Mr Adkins advocates that city council should not allow Kettering Health Network to provide healthy competition for Premier (Atrium) which would indirectly amount to the city providing Atrium financial support. Something doesn’t smell right. Council, you were elected to serve the citizens of Middletown not protect Atrium from competition!

The Sunday Journal News, October 8, 2017 contained and presented multiple sides and view points concerning the Kettering Medical Facility’s rezoning request.

Mr Adkins has repeatedly pulled this item from council agenda over the last month or so. The reason for this? … might be Mr Adkins’ method of conducting and controlling city business while, by his own admission, circumventing the Sunshine Law (which was addressed on this forum and on Mr Adkins own blog in February of 2017).

Quote from the City Manager’s Blog titled “City Council Deliberations” and dated February 17, 2017:

“My policy has always been that City Council can ask anything about anything on the agenda up until Tuesday night.  On Tuesday night, I want them to come to Council with all of their questions answered and with a full understanding of what I want them to vote on.  The only question Tuesday night should generally be whether or not to pass the legislation presented.  They should fully understand what we are proposing and why we believe it is in the best interest of the city to pass the requested legislation.”

“If there is a serious problem with what I have proposed, generally it would have been raised by City Council two weeks ago when I first told them what was coming on the agenda.  At that point, we can either answers questions and provide information sufficient to resolve their concerns, or we can pull the items from the agenda before we finalize the meeting because City Council is not ready to move forward with whatever the issue is in its current form.”

“So theoretically, Tuesday is a pretty mundane experience.  All questions previously and completely answered.  All information previously provided. City Council makes a fully understood and educated decision on each piece of legislation.”

To sum it up, Mr Adkins will “pull items from the agenda” until “City Council makes a fully understood and educated decision” … the desired decision that Mr Adkins has dictated. And there will be no deliberations since the vote has been predetermined out of public view, thereby circumventing Sunshine Laws.

In the instance of Kettering Medical Facility rezoning, perhaps Mr Adkins has not sufficiently ‘educated’ the council to vote (as he wants) against the rezoning, thus the delay.

But this delay may have backfired! Kettering Health Network placed a “cover sleeve” on the Sunday paper titled “Health Care … How It Should Be” which thoroughly explains why Middletown needs Kettering Medical’s full service, comprehensive care facility. By way of comparison, Premier/Atrium’s defensive duplicate full page ads appear even more “whiny.” Unbelievably, they try to claim that another medical facility will not create jobs and may even do the opposite. Seems the fear of competition for their high cost ,below standard services (according to United Healthcare) has perverted their ability to think logically.

In addition, there is a front page article which addresses healthcare costs; specifically the dispute between United Healthcare and Premier/Atrium that exposes numerous serious problems (of Atrium’s own creation) that are the real reasons for Atrium’s ‘failure to thrive’ and inability to compete.

Premier Health had a full page ad in Sunday 10/1/17, Journal News, defending Atrium Medical Center against the possibility of competition from the proposed new Kettering Medical facility. They really must feel very threatened!!

First, a little background … When Premier built Atrium, they insisted, unnecessarily, that the Middletown Regional Hospital be demolished (perhaps insuring that they would have no competition). City Council agreed to this. The new hospital has approximately half the number of beds that the old hospital had. So Middletown lost half the capacity for local hospital patients.

Basically, all the rooms at Atrium are private, for which Atrium charges a higher rate than surrounding hospitals. Since lower priced semi-private rooms are not available, all the patients pay a premium price. But, some major health insurance companies, like United Healthcare, will not agree to pay the private room, higher rate. Looks like Atrium has priced itself out of business. Before admitting some patients whose insurance may not cover the hospital bill, Atrium has demanded they sign a statement that they will be personally responsible for payment of their care. Also, some insurance companies have informed people who live in this area that they do not think the outcome of care at Atrium meets their standards. What’s worse is, some city employees are insured by United Healthcare!! So, all of those city employees must go out of town for in-hospital care. For example, the accident involving Detective Justin Camper. He was flown to Miami Valley Hospital in Dayton for treatment!

Now Mr Uhl, president of Atrium, has taken out a full page ad to whine about having some “healthy” competition which will not present the previously mentioned problems for patients. Those problems were created by Atrium itself. Middletown is paying for their poor judgement. Kettering would supply sorely needed, much better insured coverage, locally, which Atrium obviously can not.

When will Middletown City Council get it’s head out of … the sand and make decisions for the good of the citizens?