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Hospitals that overcharge can’t be shamed

rodin

“Eve {Shamed} After the Fall,” by Rodin.

Overcharging of hospital patients and insurers, overwhelmingly concentrated in the for-profit sector, continues apace, with “shaming” not working, reports HealthcareDive and The Washington Post.

The news service referenced a  study last year  that outed 50 hospitals that were charging patients more than 10 times the actual cost of care, compared to the typical 3.4 times the cost of care markup.

With 20 of those hospitals  in Florida (perhaps the national epicenter of Medicare fraud),  a separate  study this year by researchers at the University of Miami looked into whether those Sunshine State hospitals lowered their prices in response to public pressure.

The study found that charges were  higher overall after the publicity. Good news for shareholders of  such hospital companies as HCA if not for patients and insurers!

HealthcareDave wrote: “The findings indicate any impacts from price shaming are fleeting and provide no controls over hospitals, which leaves them accountable to no one, study author Karoline Mortensen told The Washington Post.

“The study raises questions about how effective efforts toward price transparency will ultimately be if many hospitals don’t mind reputations for high costs due to factors including lack of competition, and lack of price regulation in all states but Maryland and West Virginia.”

“The hospitals may also be counting on patients to maintain an assumption that higher prices are tied to better care, but the study found the opposite to be true, concluding 20 hospitals studied were actually less likely than other Florida hospitals to earn three or more stars in CMS’s quality metrics system.”

Of the 20 Florida hospitals,  one was a nonprofit and the rest were part of the Hospital Corporation of America (HCA) system or linked with Community Health Systems.

Interestingly, some years ago, HCA pleaded guilty to 14 felony counts and paid out more than $2 billion to settle lawsuits arising from fraud. Then Chairman and CEO Rick Scott was forced to resign at the beginning of the federal investigation. He now, of course, is governor of Florida!

To read the HealthcareDive article, please hit this link.

To read The Washington Post article, please hit this link.


Urgent-care centers seen continuing to surge

clinic

 

A 2014 whitepaper from McGuireWoods and the Urgent Care Association of America predicted that the urgent-care industry will continue to surge,   estimating that some large metropolitan areas could support two to three times the number of current urgent-care providers than they do now (or at least in 2014).

There’s a sign of this  in Revelstoke Capital Partners’ recent acquisition of SCP Urgent Care, doing business as Fast Pace Urgent Care.

From Becker’s Hospital Review, here are  seven things to know about the transaction in particular and  urgent-care centers’ growth in general.

“One of the players in the transaction is Brentwood, Tenn.-based Fast Pace, a provider of urgent-care and primary-care services. Since 2013, the company has grown from seven clinics in Tennessee to 36 clinics in Tennessee and Kentucky. The growth came primarily through opening 26 new locations and acquiring three locations. Fast Pace is a portfolio company of Shore Capital, a Chicago-based private equity firm focused exclusively on microcap healthcare investments. The other player in the transaction is private-equity firm Revelstoke, which focuses on building healthcare and business-services companies.”

In other notable recent transactions:

Last November, Nashville-based Hospital Corporation of America bought Urgent Care Extra’s Nevada operations, which include 14 urgent-care centers in Las Vegas.

In February, San Francisco-based Dignity Health said it was teaming with Atlanta-based  in a  venture to bring consumer-focused urgent care to the Bay Area.

In August 2015, Boston-based Partners HealthCare announced plans to open as many as 12 urgent-care clinics.

Becker’s noted that these investments are driven partly by the large numbers of  active patients older than 50 who want more convenient care for injuries and illness while being linked to larger systems where their regular physicians may practice and where visits to urgent-care clinics can become part of their medical record.

To read a McGuireWoods white paper on this, please hit this link.

To read a Becker’s Hospital Review overview on this, please hit this link.

 

 

 


Bold plan to reform malpractice-tort system in Georgia

courtroom

Charles R. Evans, retired president of Hospital Corporation of America and current president of International Health Services Group, endorses an effort to reform Georgia’s medical-malpractice system.

Becker’s Hospital Review reports that “A proposal before the state Senate Health and Human Services Committee calls for repealing Georgia’s medical malpractice system and replacing it with an administrative model. Under the proposed Patients’ Compensation System, medical malpractice cases would be brought before an administrative panel of healthcare experts and an administrative law judge rather than the court.”

“During my 40 years of leading hospitals, I can say that the majority of physicians I met have been sued — many under frivolous circumstances. As a result, doctors have changed their behavior to practice wasteful defensive medicine to protect themselves,” wrote Mr. Evans in a recent Gwinnett Daily Post opinion piece.

Mr. Evans argues that physicians would no longer need to practice defensive medicine under the PCS model.

“Patients would be compensated in an amount similar to what they would receive after years in the legal system. This no-blame, administrative model would eliminate the adversarial relationship between patient and doctor and allow physicians to acknowledge their errors without fear of litigation,”  he wrote.


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