Modern Healthcare articles from June 2009

Modern Healthcare archives from June 2009

Manufacturing demand; Vendor says quality, not profits, behind institute.
June 1, 2009... Byline: Jean DerGurahian A leading provider of bedside computer applications for patient engagement is promoting the use of its own and similar products by creating and helping fund a not-for-profit institute devoted to researching...

The audits are in the mail; First RAC letters could arrive as early as this week.(recovery audit contractor program)(Recovery Audit Contractor)
June 1, 2009... Byline: Jennifer Lubell It may be the calm before the storm for providers subject to the Recovery Audit Contractor program. As soon as this week, the first audit letters requesting medical records of hospitals are expected to be sent...

Down, but not out; AMA's revenue, membership fall in '08, expenses up.(Financial report)
June 1, 2009... Byline: Andis Robeznieks The American Medical Association's expenses were up while its revenue and membership were down in 2008, according to its recently released annual report, but it could have been worse. Revenue at the...

Nuclear bombshell; Isotope shortage could affect medical imaging.
June 1, 2009... Byline: Melanie Evans U.S. hospitals, clinics and imaging centers face an ongoing shortage of an essential ingredient in most nuclear medicine imaging. Repairs to a Canadian nuclear reactor that produces one-third of the world's supply...

Do med centers and devices mix? R&D efforts aimed at creating high-tech positions.
June 1, 2009... Byline: Shawn Rhea A number of academic medical institutions have announced medical-device research and development initiatives in recent weeks as part of efforts that some states are making to refocus their manufacturing industries and...

What's next for managed care? CEO roundtable participants debate key issues for insurers and health plans as the reform debate advances.(Discussion)
June 1, 2009... David Burda: Why don't we start off with reaction to President (Barack) Obama's first 100 days in office and your perspectives on his progress or lack of progress on healthcare reform. Larry Boress: I think frankly he's been very...

Video.(Brief article)
June 1, 2009... This special report on the future of managed care under different healthcare reform scenarios is based on a roundtable discussion held on May 4 with three prominent leaders involved in the purchase, design and administration of health insurance...

Adding some sweetener; Stimulus law gives banks an extra tax break on bond investments.(Obama, Barack)
June 1, 2009... Byline: Melanie Evans One of the many efforts out of Washington this year to remedy tight credit markets offered banks a limited chance to double-dip on tax breaks to invest in municipal bonds. But will banks take the plunge? The...

Lack of discipline? Report says hospitals fail to keep doctors in check.
June 1, 2009... Byline: Andis Robeznieks A new study suggesting that hospitals disciplined fewer physicians in recent years has the consumer advocacy backer of the studyPublic Citizenclaiming hospitals have dropped the ball. But an official for the...

Management consulting firm survey opens.(Survey)(Brief article)
June 1, 2009... Modern Healthcare is conducting its sixth annual Healthcare Management Consulting Firms Survey. This survey is intended for U.S. management consulting firms serving the healthcare industry. To participate and to be e-mailed a link to the...

Finding satisfaction; Sorting out how patients rate hospitals.
June 1, 2009... Byline: David Burda Money can't buy you love. But can love buy you money? Maybe. But not in healthcare. Welcome to Modern Healthcare's ninth annual 100 Top Hospitals supplement. Like past supplements, this special edition attempts to...

CBO: Not a federal expenditure; Expert says budget report buoys reform optimism.(Congressional Budget Office)
June 1, 2009... Byline: Matthew DoBias A push to reshape the U.S. healthcare system got a substantial boost last week as federal actuaries said that they would judge an effort to insure all Americans as a revenue generator rather than a new federal tax....

Bill of wrongs; Healthcare reform opponents twist the true idea of patients' rights.
June 1, 2009... Byline: Neil McLaughlin Published reports have said recently that opponents of healthcare reform have seized on "patient rights'' as a theme in their efforts to squelch any legislative initiatives. According to these reports, the advice is...

Where are the retail clinics? In more advantaged neighborhoods, report finds.
June 1, 2009... Byline: Rebecca Vesely Retail clinics are augmenting care to the insured and affluent rather than providing a primary source of care to low-income uninsured, concluded a study released last week. Contrary to some reports, retail...

ON THE MOVE...(David Shade appointed by Huron Consulting Group)(Willard Tom appointed by Federal Trade Commission)(Annmarie Hagan appointed by Cigna Corp)
June 1, 2009... CONSULTING David Shade was named president and COO of Huron Consulting Group, the Chicago-based firm that bought Shade's former firm Wellspring Partners in January 2007. Shade, 64, has been the leader of Huron's healthcare consulting...

Calif. may lose SCHIP; Mounting fiscal woes have governor taking action.(State Children's Health Insurance Program)
June 1, 2009... Byline: Rebecca Vesely California's serious fiscal crisis is threatening to undermine its healthcare safety net, and if approved by the Legislature, cuts proposed by Gov. Arnold Schwarzenegger will likely put more pressure on hospitals to...

ASIDES & INSIDES.(brief)
June 8, 2009... Beware what surprises lie inside the "room of horrors' Back when Outliers was youngbefore portable music and movie devices, and before automakers installed TV screens in the back seats of cars to help distract kids during long tripsthere...

Left out of the discussion; Single-payer advocates still trying to be heard.
June 8, 2009... Byline: Gregg Blesch Lawmakers trying to get sweeping healthcare legislation passed this summer have made a pointand a showof keeping disparate industry and advocacy groups engaged in the discussions. The only ones with no seat at the...

A storm in Southern California; Tri-City Medical beset by infighting, money woes.(Tri-City Medical Center)
June 8, 2009... Byline: Rebecca Vesely A public district hospital north of San Diego is in turmoil, with the board of directors suspending nine top administrators; physicians in revolt over how the hospital is being run; patient census and revenue...

Into the red; Annual survey of hospital systems shows not-for-profits posted an overall net loss in 2008; for-profit chains bucked the trend.(Survey)
June 8, 2009... Byline: Joe Carlson and Vince Galloro Not-for-profit hospital systems lived up to their names in 2008, with heavy investment losses dragging overall net incomes at the systems well below zero, according to the results of Modern Healthcare's...

One has state-federal issues ... Mann to deal with entitlement vs. flexibility: Smith.(appointment Mann, Cindy)
June 8, 2009... Byline: Jennifer Lubell Cindy Mann will have a lot on her plate when she takes the helm of the CMS' Center for Medicaid and State Operations as its director, scheduled for June 8. Mann, who most recently served as a research professor...

Healthcare stalling in Motor City; GM's problems has healthcare revenue downshifting.(General Motors Corp.)
June 8, 2009... Byline: Gregg Blesch A revitalized General Motors Corp. may indeed emerge quickly from bankruptcy, if the measured optimism from Detroit and Washington comes true, but the automaker will be much smaller no matter how successful, and the...

Minnesota showdown; Steeper job cuts expected if Pawlenty doesn't relent.(Tim Pawlenty)
June 8, 2009... Byline: Joe Carlson Twin Cities health systems are hemorrhaging jobs by the hundreds, but observers in Minnesota say the state's hospitals are likely to slash payrolls even deeper if state funding cuts are allowed to stand or grow even...

Doing the right thing; Healthcare industry can reform itself with the right motivation.
June 8, 2009... Byline: David Burda When my kids get in trouble, their first line of defense to avoid being punished by me or my wife is to make certain promises. They'll swear to do their homework every night. They'll vow to make their beds. They'll...

... for another it's transparency; Hamburg creates task force, GAO issues reports.
June 8, 2009... Byline: Shawn Rhea Just two weeks after being sworn in as the Food and Drug Administration's new commissioner, Margaret Hamburg is being prodded to address a number of structural issues dogging the agency including improving transparency,...

Small change, big savings?(Obama, Barack)
June 8, 2009... Byline: Matthew DoBias For months the White House has tied its goal of fixing the U.S. healthcare system to an effort to mend the overall economy. Early last week, Obama administration officials connected the dots. Using unofficial,...

UAB cutting 245 jobs.(University of Alabama at Birmingham Health System)(Brief article)
June 8, 2009... Byline: Jean DerGurahian The University of Alabama at Birmingham Health System said it is cutting 245 jobs to save an estimated $15 million to $20 million a year, following the results of a performance review. The jobs are primarily in...

Late News.(brief)(united states oncology)
June 8, 2009... Bills seeks to elevate MedPAC to executive branch agency Rep. Jim Cooper (D-Tenn.) introduced companion legislation to a bill introduced by Sen. Jay Rockefeller (D-W.Va.) that would elevate the powers of the Medicare Payment Advisory...

AMGA's profits down; Form 990 shows revenue, expenses up.(American Medical Group Association)(Financial report)
June 8, 2009... Byline: Andis Robeznieks Profits were down in 2008 at the American Medical Group Association, based on its Internal Revenue Service Form 990 tax filing. The association took in more money in 2008 than it did the year before, but it also...

Promises and threats; Leading industry groups are vowing to help the White House cut healthcare costs, but reform-hungry.
June 8, 2009... Byline: Melanie Evans Healthcare providers have little to worry about when it comes to the pledges offered by six major industry players last week to try to help the White House curb healthcare costs: The pledges offer little that's new...

ON THE MOVE...(brief)(appointments of Kelly Barnes, Mike Blanchet and Donald Stelly )
June 8, 2009... CONSULTING PricewaterhouseCoopers named Kelly Barnes to lead its U.S. health industries practice. Barnes, 42, has been with the firm's leadership team since 2007, most recently as the leader of sales and marketing, according to a news...

Nominate a doc-entrepreneur.
June 8, 2009... Modern Physician, Modern Healthcare's sister publication, is now accepting nominations for its second annual Physician Entrepreneur of the Year awards program. The award recognizes physicians who have made their mark on the business side of...

LTACs to pay for CMS' error; Agency to revise relative weights rule for '09, '10.(long-term acute care hospitals)(Centers for Medicare and Medicaid Services)
June 8, 2009... Byline: Jessica Zigmond A midgame rule change from the CMS could mean a no-win situation for long-term-care hospitals, experts said last week in response to announced payment changes for the remainder of 2009 and all of 2010. Late on...

Land of the lost; GAO scolds IHS on $3.5 million in missing property.(Government Accountability Office)(Indian Health Service)
June 8, 2009... Byline: Jessica Zigmond Not long after learning about a new stream of federal funding, the Indian Health Service was chided by the Government Accountability Office last week for continuing to lose millions of dollars in lost and stolen...

Some wary of RAC's cousin; Exec: MIC makes RAC seem like child's play.(medicaid integrity contractors)(recovery audit contractors)
June 15, 2009... Byline: Jennifer Lubell The CMS is attempting to clarify the role of new federal contract audits being performed under Medicaid that providers fear will operate in a similar fashion to the controversial Recovery Audit Contractor program in...

Medicare savings ID'd.
June 15, 2009... Byline: Matthew DoBias The Obama administration said it has identified an additional $313 billion in savings, primarily from Medicare, which will translate into lower federal payments to hospitals. The lion's share of the cuts will come...

Borrowing bounces back; Bond issues on pace to topple '08 figures.
June 15, 2009... Byline: Vince Galloro In February, Tenet Healthcare Corp. was able to push back the due dates on about $1.4 billion in bonds, and the company paid for the privilege in higher interest rates on the new bonds. This month, the Dallas-based...

Maine revamps funding formula.
June 15, 2009... Byline: Rebecca Vesely A slew of new laws enacted last week in Maine change the funding mechanism for its universal healthcare program, tighten certificate-of-need rules and boost surveillance reporting on hospital-acquired infections. ...

Making a comeback; While interest rates are still more costly and financings more complex, credit continues to loosen.
June 15, 2009... Byline: Melanie Evans The nation's jarring credit shakeout has rapidly altered healthcare financing's landscape for the majority of U.S. hospitals. Significant investors in the tax-exempt bond market disappeared during the past year,...

Outliers Asides & Insides.(laws putting limits on gifts offer by medical representatives)(use of sanitizing detector for hospital employees )(global swine flu pandemic )
June 15, 2009... Tales of the Donald, the healthcare edition Amway. Herbalife. Mary Kay. Shaklee. Trump? Yes, the Donald's newest business venture is taking him into the world of multilevel marketing, hawking a line of customized health regimens. So...

New tourist attractions; More patients looking at home before going abroad.
June 15, 2009... Byline: Jennifer Lubell Galichia Heart Hospital in Wichita, Kan., recently decided that it could break into a market monopolized by overseas hospitalsand offer high-quality, more-convenient care to patients. In conducting research of...

Charitable definitions; HFMA takes strict stance on charity care.(Healthcare Financial Management Association)
June 15, 2009... Byline: Melanie Evans As not-for-profit hospitals prepare for more detailed public disclosure of their charity care, a major healthcare finance association offered ideas on how hospitals might determine whether a patient's unpaid account...

Dem leaders hash out reform ... ... as GOP lawmakers say they're being left out.
June 15, 2009... Byline: Matthew DoBias Three healthcare reform bills are on a collision course in Washington, with President Barack Obama urging lawmakers to stick to an aggressive timeline that could result in votes next month. But before then,...

Late News.(briefs)
June 15, 2009... Leaders say status quo for CDC despite pandemic announcement Leaders at the Centers for Disease Control and Prevention said that the World Health Organization's declaration of the world's first pandemic in 41 years will not change the...

On the move.(appointments)
June 15, 2009... ASSOCIATIONS Anthony Tersigni, president and CEO of Ascension Health, St. Louis, was named vice chairman and chairman-elect of the Catholic Health Association's board of trustees at the CHA membership assembly in New Orleans. Colleen...

Einstein ends affiliation with Jefferson; Philadelphia-based system to pay $130 million to complete `amicable separation'.
June 15, 2009... Byline: Jessica Zigmond Just as a hospital's vision could lead to consolidation in Denver, it has led to separation in Philadelphia, where the Albert Einstein Healthcare Network last year broke away from the Radnor, Pa.-based Jefferson...

More than an ounce of prevention; There's value, wisdom in the push for wellness, but commitment must be sustained.
June 15, 2009... Byline: David May By almost all accounts, this country stands ready to redouble its work on wellness promotion and illness prevention. As health reform bills begin to roll out, it's clear that this is going to be one area where Congress...

The moral is the story; An arbitrator in Denver recently ruled that a Catholic system cannot buy out its secular sponsor-at least not for money-which exemplifies the difficulty of such relationships.
June 15, 2009... Byline: Joe Carlson The pitfalls of joint operations between secular and religious hospital groups was made clear in Denver last week when an arbitrator ruled that one foundation trying to get out of such a deal could not accept a $311...

AMA's moment; Obama visit makes news, but group's role unsure.(American Medical Association)
June 22, 2009... Byline: Andis Robeznieks President Barack Obama's visit to last week's meeting of the American Medical Association House of Delegates in Chicago made a big splash, but whether the speech and follow-up from the physician group will have any...

Retail rumble; MinuteClinic faced a tough fight in opening outlets in Mass., and it's still not welcome in Boston.
June 22, 2009... Byline: Andis Robeznieks The most tangible outcomes of a volatile three-year medical-political struggle in Massachusetts appear to be that you can now get your rash examined in a CVS pharmacy, but you can't buy cigarettes while you're...

Ouliers Asides & Insides.(lobbying for health care reform)
June 22, 2009... On the road to reform with a big purple bus Perhaps you recently spied a purple bus chugging down the highway and feared a Barney the dinosaur concert replete with thousands of screaming toddlers was headed to a venue near you. But Outliers...

Arguing over money; Reform debate turns to costs, reimbursement cuts.
June 22, 2009... Byline: Matthew DoBias Money took center stage in the national healthcare reform debate as battle lines continued to form over how much reform would cost and who would pay for it. At the behest of the American Hospital Association, the...

Improve or lose; Maryland pegs reimbursement to reducing complications for 52 conditions.
June 22, 2009... Byline: Jean DerGurahian Hospitals in Maryland are warily eyeing the July start date of a new reimbursement program by the state that takes the concept of not paying for hospital-acquired adverse medical conditions to a much larger scale....

Tough times could get tougher; Attendees concerned over possible reimbursement cuts.
June 22, 2009... Byline: Melanie Evans Chief financial officers and other financial executives attending the Healthcare Financial Management Association's 2009 Annual National Institute in Seattle last week were given advice about how to deal with an...

Catholic labor's guiding light? U.S. bishops' conference to release `blue print' for management on union issues.
June 22, 2009... Byline: Joe Carlson The U.S. Conference of Catholic Bishops is scheduled to release a comprehensive set of principles this week intended to guide hospital executives in negotiating contracts with labor unions that ideally would make that...

Dealing with personnel issues; To cut costs, systems seek ways to boost production, such as streamlining services.
June 22, 2009... Byline: Shawn Rhea In 2007, Danville, Pa.-based Geisinger Heath System partnered with one of its payers, sister company Geisinger Health Plan, to launch a quality improvement initiative called Personal Health Navigator. The program, which...

Dueling views; Dems support employer mandates, business doesn't.(health care reform; employee health care benefits)(Brief article)
June 22, 2009... Byline: Rebecca Vesely With healthcare reform on the fast track, the question of whether employers should be required to provide coverage to their workers or pay the government to do so is taking center stage, with top Democrats supporting...

Emphasizing payment; Doc groups see reform through reimbursement prism.
June 22, 2009... Byline: Jessica Zigmond Physician groups emphasized payment reform as a key component in changing the nation's healthcare system after House leaders last week drafted legislation that would permanently alter the formula that calculates...

Under the gun; Providers would have to jump through higher and higher hoops to qualify for IT payments the longer they wait.
June 22, 2009... Byline: Joseph Conn A federal advisory panel sought to strike a balance between too much of a stretch and too little when it released a first draft of its so-called "meaningful use'' recommendations last week. Their work was an early...

Cat's still in the bag ... ... but things could get ugly if it gets out that revenue is prime motivator.
June 22, 2009... Byline: Neil Mclaughlin Cat's still in the bag... ... but things could get ugly if it gets out that revenue is prime motivator Last week's massive protests in Iran brought to mind a pronouncement from the eminent healthcare...

Corrections & Clarifications.(Correction notice)
June 22, 2009... * The June 15 article "The moral is the story,'' (p. 6), misidentified a speaker at a June 8 session of the Catholic Health Association. The speaker was William Murray, president and CEO of Sisters of Charity of Leavenworth Health System.

Hackensack change coming; CEO Ferguson retiring; Garrett named acting chief.(John Ferguson to be replaced by Robert Garrett as president of Hackensack University Medical Center)(Brief article)
June 22, 2009... Byline: Jessica Zigmond Hackensack (N.J.) University Medical Center said John Ferguson will retire as president and CEO on July 1. Robert Garrett, the hospital's executive vice president and chief operating officer, was named acting...

Being held accountable; Scrushy ordered to pay billions; L.A. exec pleads guilty.(HealthSouth former chief executive officer Richard Scrushy)
June 22, 2009... Byline: Gregg Blesch Innovation is appreciated in healthcare, but executives have been reminded again to dedicate their creativity to the money they can earn providing care to patientspatients who need it. Richard Scrushy is now on the...

Isotopes on the ropes; Molybdenum-99 shortage has some clamoring for U.S. production.
June 22, 2009... Byline: Jessica Zigmond A major problem stemming from the recent shutdown of a Canadian nuclear reactor is more about economics than physics, as nuclear and medical experts asked Congress for funding to solve the current supply-and-demand...

In the spotlight.(Arthur Gonzalez appointed as CEO of Hennepin Healthcare System)(Brief article)
June 22, 2009... Byline: Rebecca Vesely Arthur Gonzalez has been named the new CEO of Hennepin Healthcare System, Minneapolis, after his tumultuous departure from Tri-City Healthcare District in Oceanside, Calif. Effective June 30, Gonzalez replaces...

On the move...(executibes in the health care industry)
June 22, 2009... HOSPITALS, SYSTEMS Stanley Hupfeld, president and CEO of Oklahoma City-based Integris Health, will no longer serve in that role when he becomes chairman of Integris Family of Foundations on Jan. 1, 2010, the health system said in a news...

Late News.(healthcare workers caught swine flu; antitrust clearance for Prince William Health System and Suburban Hospital Healthcare System; Health Net services; David Wessner of Park Nicollet to retire)
June 22, 2009... Flu precautions not always followed by sick workers: CDC Half of healthcare workers infected with H1N1 influenza A, commonly known as swine flu, acquired the virus in a healthcare setting and did not use all recommended forms of personal...

Out of the debate; Immigrants are missing quotient in reform talks.(health care reform)
June 22, 2009... Byline: Joe Carlson As Congress considers different reform proposals, one sizable group of the uninsured appears destined to remain outside the reform conversation no matter what plan becomes law. Illegal immigrants make up a large...

Walking on Golden eggshells; Some Calif. hospitals sweating seismic mandates.
June 22, 2009... Byline: Rebecca Vesely Seton Medical Center is no stranger to catastrophe. Just before its grand opening in 1906, Seton was destroyed by the infamous San Francisco earthquake and fires. Another earthquake damaged the San Francisco...

LABOR ACCORDS.(hospital and labor unions)(Brief article)
June 22, 2009... Labor accords, which are gaining favor as a means to keep peace between hospitals and labor unions, often include: * Both sides can agree to pre-screen one another's literature about the union before distribution. * Management may...

Making a break; More hospitals attempt to leave Health Alliance.(Health Alliance of Greater Cincinnati)
June 29, 2009... Byline: Gregg Blesch The Health Alliance of Greater Cincinnati may lose another hospital and perhaps two, rendering it a much smaller system than it once was and not much of an alliance at all. The alliance not long ago ended a...

Outliers Asides & Insides.(news from health care industry)
June 29, 2009... Keeping an eye on the weather, healthcare style In case you were wondering, there doesn't seem to be much relationship between a good mango season and the number of hurricanes that land on Florida during a year. This is only one tidbit...

Public enemy No. 1; A new public insurance program likely will shortchange providers.
June 29, 2009... Byline: David Burda Healthcare executives who care about the financial future of their organizations should do everything they can to defeat any healthcare reform bill that would create a new public health insurance program. Not only is...

... but little other progress; HELP panel is beset by partisan squabbling.(Senate Health, Education, Labor and Pensions Committee)
June 29, 2009... Byline: Jennifer Lubell Partisan squabbles and last-minute work on key coverage provisions have slowed progress on a Senate Health, Education, Labor and Pensions Committee healthcare reform bill, the Affordable Health Choices Act. ...

Fiscal breakthrough ... Reform proposal trimmed to $1 trillion in Senate.
June 29, 2009... Byline: Matthew DoBias Healthcare reform took a step toward reality last week after days of haggling over its mounting expected cost. Members of the Senate Finance Committee reached a breakthrough just before they recessed for one week...

Some IT insight; How we whittled 48 entries down to the top five.(information technology)
June 29, 2009... Byline: David Burda If you're looking to add meaning to your healthcare information technology project, you've come to the right place. Welcome to Modern Healthcare's inaugural IT Case Study Contest, where you, the reader, have the...

Regulating returns; IHI program targets three states' readmission rates.(Institute for Healthcare Improvement)
June 29, 2009... Byline: Jean DerGurahian Through a new initiative aimed at reducing rehospitalizations among patients, hospitals in three states are taking on an issue that regulators and quality advocates are increasingly targeting as they explore the...

A retiring bunch; Major issues like financial pressures, healthcare legislation can sometimes send CEOs scrambling for the door.(chief executive officers)
June 29, 2009... Byline: Joe Carlson A new wave of CEO departures has started building in recent weeks, as revenue problems continue to mount and federal officials attempt to shrink federal payments that might reliably bring in at least some cash. The...

Upward trend; NQF adds to upper management as its role expands on performance measurement.(National Quality Forum)
June 29, 2009... Byline: Andis Robeznieks While others have made news with layoffs and cutbacks, the National Quality Forum has made three significant hires this year in order to handle its increasing workload and the expanding role being played by its...

Challenging China; Supply chain could be affected by raw materials dispute.
June 29, 2009... Byline: Shawn Rhea A global trade dispute over raw materials could affect the cost of producing surgical instruments, hospital beds, operating room tables and other healthcare equipment and supplies. In a move that if successful could...

Universal with a twist; Make true costs of healthcare services clear to patients.
June 29, 2009... Byline: Joel Dickerman For almost 50 years, private and publicly funded healthcare plans have tried to make healthcare more accessible by making the cost of that care more convenient. Initially, these plans reimbursed patients for...

Insurers feel heat again; Hearing focuses on billing and marketing practices.
June 29, 2009... Byline: Rebecca Vesely Health insurers are again under scrutiny for billing practices as they buff their public image amid heated healthcare reform talks on Capitol Hill. Leaders of a key Senate committee last week blasted insurers for...

Trust issues; Obama administration plans to take more regulatory approach on healthcare mergers.
June 29, 2009... Byline: Gregg Blesch As a candidate for U.S. president, Barack Obama said that the Bush administration had "perhaps the weakest record of antitrust enforcement of any administration in the past half-century.'' Over the past few months,...