The Smoldering Issue of Trustee Liability for Poor Hospital Quality: A Firestorm whose time has come (John P. Marren, Abstract)

Written by: John P. Marren, Partner, Hogan Marren Ltd., Chicago, Illinois

This article focuses on the pervasiveness of the quality problem from the perspective of quality professionals; the contributing factors to the quality problem; institutional resistance to change and the process of accomplishing change.

The Hospital Board at Risk and the Need to Restructure the Relationship with the Medical Staff: Bylaws, Peer Review and Related Solution (Annals of Health Law, Loyola University, June 2003)

Written by: John P. Marren, Partner, Hogan Marren Ltd., Chicago, Illinois; G. Landon Feazell, President, QualVal, Daytona Beach, Florida; Michael W. Paddock, Associate, Hogan Marren, Ltd., Chicago, Illinois

This extensive article is intended to introduce a central thesis and pose the fundamental question for consideration: Does the current structure of the hospital governing board and medical staff support and promote quality and patient-centered care, or is it seriously flawed?

Managed Care Under The Gun; Suing Your Managed Care (Managed Care Quarterly, Spring 2001)

Written by: John P. Marren and Michael Paddock, Hogan Marren, Ltd

Since the early nineteen-seventies America has struggled with the cost of providing quality health care to its citizens. In an attempt to control these costs, Congress blessed our healthcare system with formal managed care legislation in 1973. One year later, Congress passed legislation that preempts a large majority of state law claims against managed care organizations. This legislation, the Employee Retirement and Income Security Act (ERISA), has effectively been an iron safe for managed care.

This complicated system of contractual medicine involved several new aspects, including pre-authorization for care, medical necessity determinations, gatekeeper physicians, capitation and many other hoops for both providers and subscribers to jump through. The result was that, for the next thirty years, patients - or, rather, subscribers - provided both their congressional leaders and the courts with a litany of managed care's failures.

The Emperor Has No Clothes (Trustee, July/August 2000)

Written by: Allan Fine - CHPS Consulting; John P. Marren, J.D. - Hogan Marren, Ltd.
Special Thanks to David Van Horn - Consultant

Stand-alone hospitals are becoming something of a rarity on the American landscape. While hospital boards have repeatedly voted to form systems in the last 10 to 20 years, they have been just as likely to neglect to identify specific, measurable benefits that a merger would bring to their institution. And even if they did, they frequently discontinued evaluating whether system formation brought the hoped-for benefits, thereby justifying ongoing system participation. It is an incumbent fiduciary obligation to continually ask the question: Does continued participation make sense; that is are we appropriately exercising stewardship over the hospitals' or system's assets by participating in this system? In a sense, boards are in danger of becoming like the emperor in the children's fairy tale, believing they have done the right thing without taking a hard look at today's reality.

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