A Giant (Bain-owned) Hospital Chain Is Blazing a Profit Trail

[Scuba]

http://www.nytimes.com/2012/08/15/business/hca-giant-hospital-chain-creates-a-windfall-for-private-equity.html

In fact, profits at the health care industry giant HCA, which controls 163 hospitals from New Hampshire to California, have soared, far outpacing those of most of its competitors. The big winners have been three private equity firms — including Bain Capital, co-founded by Mitt Romney, the Republican presidential candidate — that bought HCA in late 2006.

...

Among the secrets to HCA’s success: It figured out how to get more revenue from private insurance companies, patients and Medicare by billing much more aggressively for its services than ever before; it found ways to reduce emergency room overcrowding and expenses; and it experimented with new ways to reduce the cost of its medical staff, a move that sometimes led to conflicts with doctors and nurses over concerns about patient care.

In late 2008, for instance, HCA changed the billing codes it assigned to sick and injured patients who came into the emergency rooms. Almost overnight, the numbers of patients who HCA said needed more care, which would be paid for at significantly higher levels by Medicare, surged.

...

Many doctors interviewed at various HCA facilities said they had felt increased pressure to focus on profits under the private equity ownership. “Their profits are going through the roof, but, unfortunately, it’s occurring at the expense of patients,” said Dr. Abraham Awwad, a kidney specialist in St. Petersburg, Fla., whose complaints over the safety of the dialysis programs at two HCA-owned hospitals prompted state investigations.

"Upcoding", as it's known in the industry, is illegal. Accurately and completely documenting patient diagnosis, complications and treatment is not. Every hospital I've worked in (over 30) has been trying to accurately document every LEGITIMATE factor to help increase reimbursement.

Labor is the number one cost factor in a hospital. As not-for-profit hospitals are squeezed on costs from all sides, nursing hours per patient day drop and patient care suffers. It is NOT hospital administrators, doctors, nurses, radiology and lab techs, etc. who are responsible for America's third-rate healthcare or the first-rate prices we pay for it.

[hunter]

1. Healtcare costs so much in the U.S.A. because the hospitals and insurance companies...

... have the same goal:

The larger the streams of money they control, the more money they can skim off for the plutocracy.

Everyone else gets screwed.

The for-profit hospital and health insurance corporations ought to be nationalized. And I'm sure we could send some forensic accountants through their books and find a few people at the top deserving hefty prison sentences.

The U.S.A. needs a vigorously enforced "corporate death penalty." We are insane to let private corporations kill and maim people for profit, we are insane to let private corporations destroy our nation's middle class.

Institutions like HCA ought to be destroyed. They are a malignant cancer ripping apart our society.

[Scuba]

2. Most of the 6,000-plus hospitals in the Country are not-for-profit.

[hunter]

4. Not really. Look inside and there's plenty of profit...

...multi-million dollar incomes for insiders and sweetheart deals with vendors.

There are a few non-profits that might be acceptable as vendors in a national single-payer healthcare system, but most are cash cows for some very, very wealthy people.

[Scuba]

5. Look inside? Get real....

I worked in hospitals for more than 30 years - all in not-for-profits.

Yes, there's money being made off healthcare, but it's not by hospital employees. The very top healthcare CEO's - those responsible for large, mult-hospital systems with thousands of beds - might make two or three million. Compare that with the insurance company execs who make hundreds of millions.

Most healthcare workers make less than they are worth. Only a very tiny percentage make over $100K annually.

[hunter]

7. Yeah. Me too.

[Initech]

6. Follow the money trail. There's definitely people at the top that should be facing prosecution.

[lpbk2713]

3. Five dollars per Q-tip and ten dollars per aspirin really add up.

... not to mention double billing and billing for services not rendered.

[bobthedrummer]

8. Oh yeah, I even remember Jeb BUSH at Tenet Health Care and lots more-k&r n/t