Ho Hum. Yet Another Hospital Chain Has Been Caught with Their Hands in the Cookie Jar


This time it is Health Management Associates, based in Naples, Florida.  Or should I say it is H.M.A. yet again.

A whistleblower said H.M.A. was scoring ER doctors on their admit rates per a NYT article. The authors were Julie Creswell and Reed Abelson

“The scorecards…were just one of the many ways that Health Management Associates, a for-profit hospital chain…, kept tabs on an internal strategy that regulators and others say was intended to increase admissions, regardless of whether a patient needed hospital care, and pressure the doctors who worked at the hospital.”  H.M.A. is accused of encouraging its ER doctors to admit “at least half” of Medicare patients whether they needed to be admitted or not.

“This month, the Justice Department said it had joined eight separate whistle-blower lawsuits against H.M.A. in six states.

Enough is enough.  What can an employer do to protect its employees from this kind of thing?First, demand your PPO delete such hospitals from your PPO network. And second, set up a program to send your sickest patients to facilities that practice ethical medicine:  Virginia Mason in Seattle, Geisinger in Western PA, Mercy in Springfield, MO, The Oklahoma Heart Hospital in Oklahoma City, and others. Those four facilities, and others, are part of the new Edison Health program.

First posted on Cracking Health Costs 2/3/2014.

Thomas G. Emerick is the President of Emerick Consulting, LLC and Host of Cracking Health Costs. Tom´s years with Wal-Mart Stores, Inc., Burger King Corporation, British Petroleum, and American Fidelity Assurance Company have provided an excellent blend of experience and contacts. His last position with Wal-Mart was Vice President, Global Benefit Design. Tom has served on a variety of employer coalitions and associations, including being on the board of the influential National Business Group on Health, the U. S. Chamber of Commerce Benefit Committee, and many others. Frequently in demand as a speaker for benefits and health care conferences, such as the internationally known World Health Care Congress, Tom´s topics include strategic health plan design, global health care challenges, health care economics, and evidence-based medicine.