Religious health care as community benefit: social contract, covenant, or common good?

The public responsibilities of nonprofit hospitals have been contested since the advent of the 1969 community benefit standard. The distance between the standard's legal language and its implementation has grown so large that the Internal Revenue Service issued a new reporting form for 2008 that is modeled on the Catholic Health Association's guidelines for its member hospitals. This article analyzes the appearance of an emerging moral consensus about community benefits to argue against a strict charity care mandate and in favor of directing efficient care delivery and healthy community initiatives to underserved populations. The analysis turns on three moral conceptions of community benefits, the social contract model of hospital critics and the common good and covenantal models of Catholic and Jewish hospitals.

[Evolution of the hospital institutions of Brussels and the progressive individualization of the departments of obstetrics]

The origin of Brussels hospitals goes back to the XIIth century when several institutions created by the Church were only aimed at lodging poor pilgrims. The evolution from ecclesiastic management to municipal direction ended up in the establishment of two main public hospitals devoted to health care : Saint-Jean and Saint-Pierre. The latter, founded under Austrian rule and associated from the start with clinical teaching, gained therefore a prominent position. In 1834, it became a university hospital thanks to an agreement between the recently founded Free University of Brussels and the municipal health authorities. Finally, the administration of the main university clinical infrastructure was totally taken over by the University and moved to the newly erected Erasmus Hospital together with all faculty buildings. Development of the Brussels Maternity occurred rather slowly and underwent several location changes because of varying general politics as well as for sanitary reasons of hygiene. It was not before the XXth century that obstetrical practice progressively shifted from the private domiciliary sphere at the hands of midwives, to the hospital environment and medical control as is the case today.

The coming millennium: enduring issues confronting Catholic health care

Professor Singer and Ms. Johnson Lantz provide a cogent overview of Catholic health care in the United States and address the key issues affecting Catholic health care in the coming years. In particular, (1) clarity in canonical and ethical interpretation; (2) industry consolidation; and (3) "next generation" sponsorship and the impact of these issues are discussed in detail. The authors conclude that successful Catholic health care organizations must maintain strong mission and business fundamentals in an increasingly competitive reimbursement and regulatory environment.

Mission-driven market strategies: lessons from the field. A study of six successful Catholic systems finds mission and values clarity more relevant than ever

Convinced that Catholic organizations might have special strengths for succeeding in price-competitive markets, the Catholic Health Association, with the assistance of a national membership advisory committee and The Lewin Group, Fairfax, VA, studied six healthcare organizations that are successfully meeting the challenges of difficult environments. Based on more than 100 interviews and assessments of the environments in which these progressive mission-driven organizations operate, the researchers identified strategies that can assist other faith-based health organizations. The Lewin Group's Kevin J. Sexton, who led the research team, explained that "the study examined how the organizations embraced their mission and used their values in three areas: linkages with other organizations, linkages with physicians, and strategies for balancing delivery and insurance." CHA's executive vice president William J. Cox said the study sites were selected to obtain a range of marketplace, sponsorship, and structural experiences. "We wanted to learn how Catholic organizations responded to environmental forces with strategies that were grounded in mission," Cox said. CHA has published the study in a resource packet that describes the five major findings, profiles the cases, and provides Best Practices Checklists--specific pointers to guide organizations in their efforts. The following study excerpts provide a brief overview of the findings and a sample of the Best Practices Checklists. To obtain the complete resource, Mission-Driven Market Strategies: Lessons from the Field, call the Catholic Health Association at 314-253-3458 (for more information see the advertisement on p. 62).

When the saints go marching out. Is American health care losing its religion?

Religious groups have laid thousands of hospital cornerstones, but today's business bent is forcing hard choices about how best to minister to the poor and sick. Hospitals owned by religious communities are both numerous and endangered, with as many as half expected to change hands.

Designed for growth. Catholic megasystem CHI set to take off

A young megasystem is charting new territory in Catholic healthcare because of its size, its ownership structure, which gives laity a more prominent role, and its enviable bottom line. But Denver-based Catholic Health Initiatives' many new ventures raise questions about the future: Will CHI become an acquisition-monger? Will it be able to maintain its strong Catholic ministry?

The worker of the future. A system outlines the competencies its employees will need

In 1993, Sisters of Mercy Health System-St. Louis (SMHS), having asked itself what kind of employees it would need in the twenty-first century, established a Worker of the Future Task Force to develop tentative answers. The task force began by making projections concerning healthcare, studying the strategic plans of SMHS's members, and surveying its employees. It learned that the system should help workers see how change could benefit them. Next, the task force studied the cultural history of the Sisters of Mercy, developing from it Six Guiding Principles for the evaluation of employee performance. From these principles, the task force derived Twelve Competencies that SMHS will seek in future workers. In 1995 the system's education leaders, with the aid of an internal training organization, decided to develop 17 training modules based on these guiding principles and competencies. Since then, more than 85 SMHS employees have been trained to help coworkers develop customer service skills and other competencies. SMHS has also incorporated the competencies in its job descriptions and performance evaluations, added the Worker of the Future curriculum to its orientation program for new employees, and is currently developing Worker of the Future training sessions for human resources personnel who interview prospective employees.

Healthy communities: good mission, good sense. Holistic approach is the key

Catholic healthcare's mission is keeping people healthy, and providers must listen closely to determine their needs in these fast-paced, stressful times. In a society preoccupied with technology and acute care, which has the least overall impact on people's health, providers must implement more preventive strategies. The shift to promoting community health will require diverse, creative approaches. Catholic facilities must offer holistic healing, becoming community resources for children and the elderly. Religious institutes also must prepare for the laity's increasing role in the ministry. Providers must develop initiatives that define Catholic healthcare, such as the Welfare-to-Work Program in St. Louis, which offers women employment opportunities and benefits as a starting point to gain control of their lives. With increased school collaboration, nurses can help children develop good health habits. The guiding vision must be the health of the whole person and the community. Catholic providers must restore public trust and confidence by emphasizing person-centered healthcare. Only by becoming an integral part of the community can Catholic healthcare make a difference in people's lives.

Contemporary challenges for Catholic healthcare

In this article, Father Morrisey uses a legal approach to analyze the challenges facing Catholic healthcare in a time of rapid change, drawing his observations from his work with Catholic healthcare institutions both in Canada and in the United States.

Shaping a preferred future: Catholic healthcare beyond the year 2000

The Catholic Health Association of Canada recognizes that the Canadian healthcare system is changing. In a special supplement to the summer edition of the Review, we explored the forces at play within our healthcare environment and identified significant emerging trends. In Part II of this review, we look at the role for Catholic healthcare in Canada beyond the year 2000 by presenting the perspectives of four key spokespersons. These spokespersons outline the valuable contribution Catholic healthcare make within the Canadian healthcare system.

1996 outlook: systems, for-profit chains, medical groups, religious healthcare, managed care, post-acute care, finance, purchasing, info systems, labor, legal, construction

It's put-up-or-shut-up time for healthcare providers in 1996. Two years ago, everyone talked about fixing the healthcare system. Not much happened. Last year, providers and politicians concentrated on squeezing medical costs. According to some of Modern Healthcare's key beat reports, this year it's back to the basics of running a business.