CBS devastates HMA on 60 Minutes ==> "Hospitals: The cost of admission" | TigerDroppings.com

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NC_Tigah
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CBS devastates HMA on 60 Minutes ==> "Hospitals: The cost of admission"


The crux of 60 Minutes' inquiry centered around HMA's pressure on ED MDs to admit more patients than necessary. HMA established preset quotas the MDs were pressured to meet or exceed. >20% in several cases. Good medicine keeps patients out of hospitals. Hospitals are where the bad bugs live. Decreasing admissions and reducing hospital stay is a huge modern medical emphasis. Everything about HMAs alleged efforts runs counter to that.

CBS interviewed multiple HMA MDs and administrators. From a medical standpoint, accusations were consistent and devastating. If true, the amount of medicare fraud could be record-breaking, and corporate leadership will and should face major jail time.

HMA stock is down 5.5% today.

Here's a snippet of dialogue:
quote:

Jeff Hamby: The minute the chief complaint and their age was placed into that computer, that system ordered a battery of tests that was already predetermined.

Scott Rankin: This was prior to being seen by the treating physician. And we would look at the chart and say, "Why was all this ordered?"

The computer program also generated printed reports like this one evaluating each doctor's performance and productivity. On this document the doctors who hit corporate admissions goals received praise from company managers. Those who didn't knew it.

Cliff Cloonan: The primary purpose of the scorecard was to track how you were doing in terms of revenue generation based on number of tests ordered and number of patients admitted to the hospital.

Scott Rankin: It has nothing to do with patient safety and patient care. It has everything to do with generating revenues.

They say that when a doctor decided send to an emergency room patient home, the computer would often intervene, prompting the doctor to reconsider.

Jeff Hamby: The minute I hit "Home", it says, "Qual Check." And then it comes up with a warning, "This patient meets criteria for admission. Do you want to override?"

Steve Kroft: What was the reaction from the administrators if you overrode the computer?

Jeff Hamby: It was like being called to the principal's office.

Cliff Cloonan: Mind you, this is coming from a non-physician, somebody who never went to medical school, never did a residency. Frankly, has never seen or treated a patient, is telling a physician how they should be taking care of a patient and making decisions related to a patient. And my blood pressure's going up just saying this.

In August, a former executive vice president of the hospital chain - John Vollmer - testified under oath in a deposition, that HMA's aggressive admission policies came directly from the top: CEO Gary Newsome.

Link to the entire transcript here
If this story is even partly true, HMA personnel involved should be skinned. It highlights the increasingly intrusive, officious role of non-physicians in US healthcare. It also fits in toto with political dialog claiming similar activity is responsible for high US healthcare costs. Actually HMA's actions as detailed are not indicative of any norm in American Medicine. None. But that won't be the message arising. Assuming some truth to the story (and it sounded very credible), HMA is one hell of a bad player in the field. I've never seen anything like it on this scale.




This post was edited on 12/3 at 2:36 pm



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cwill
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re: CBS devastates HMA on 60 Minutes ==> "Hospitals: The cost of admission"


quote:

If this story is even partly true, HMA personnel involved should be skinned. It highlights the increasingly intrusive, officious role of non-physicians in US healthcare. It also fits in toto with political dialog claiming similar activity is responsible for high US healthcare costs. Actually HMA's actions as detailed are not indicative of any norm in American Medicine. None. But that won't be the message arising. Assuming some truth to the story (and it sounded very credible), HMA is one hell of a bad player in the field. I've never seen anything like it on this scale.


I watched it and agree it was pretty damning and consistent testimony from the physicians - even the former admin that was deposed.

I also think this is a big part of sky-rocketing healthcare costs, but they didn't touch on a big culprit - government involvement in the healthcare process through medicare and medicaid.






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a want
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re: CBS devastates HMA on 60 Minutes ==> "Hospitals: The cost of admission"


Their reply
quote:

According to their report, 60 Minutes conducted more than a year of research and found no issues with the quality of care at Health Management hospitals, stating on the broadcast that "hardly anyone we talked to complained about the quality of care at HMA hospitals."

It was also notable that 60 Minutes failed to identify a single patient who had been inappropriately admitted from any of the company's emergency rooms, including by the physicians interviewed. Neither 60 Minutes nor the physicians interviewed identified any admission decision in which a physician's medical judgment was overridden by an HMA executive, much less to defraud Medicare.

60 Minutes did not in any way dispute the admissions data it was provided by Health Management over the last several months. That data demonstrated that admissions rates from the company's emergency rooms were in-line with national norms and consistent over a several-year period. Instead, 60 Minutes relied entirely on disgruntled former employees of the company and former contracted physicians, several of whom are seeking financial gain through active litigation with Health Management.

On November 30, 2012, just after being notified that 60 Minutes was moving forward with its broadcast, Health Management held a conference call in which it provided key data about admissions from its emergency rooms. The information presented on the call, and additional information added since the program's airing, are instructive about the 60 Minutes segment and available for viewing on the Investor Relations section of HMA.com. read less


No mention of the computer automatically ordering unnecessary tests. And the idea that 60 mintutes will actually identify patients....lulz






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a want
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re: CBS devastates HMA on 60 Minutes ==> "Hospitals: The cost of admission"


quote:

government involvement in the healthcare process through medicare and medicaid.

Like clockwork






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Diamondawg
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re: CBS devastates HMA on 60 Minutes ==> "Hospitals: The cost of admission"


I watched it last night. We have 5 area hospitals that are HMA and I had some dealings with them when I was working. They are known to be pretty ruthless and bottom line driven. Our company was providing them with an online documentation system for the physician clinics and not the ED system (thank goodness). Apparently they have quit using. Will be interesting to see how it unfolds.





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Taxing Authority
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re: CBS devastates HMA on 60 Minutes ==> "Hospitals: The cost of admission"


The odd thing to me is that seems to be little more than template treatment. Something we're likely to see more of with increased government "panel" controlled treatment prescription.





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NC_Tigah
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re: CBS devastates HMA on 60 Minutes ==> "Hospitals: The cost of admission"


quote:

The odd thing to me is that seems to be little more than template treatment. Something we're likely to see more of with increased government "panel" controlled treatment prescription.
Bingo.

As above, "it highlights the increasingly intrusive, officious role of non-physicians in US healthcare"






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Patrick O Rly
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re: CBS devastates HMA on 60 Minutes ==> "Hospitals: The cost of admission"


quote:

Like clockwork



Go ahead and laugh. It's true.






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a want
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re: CBS devastates HMA on 60 Minutes ==> "Hospitals: The cost of admission"


quote:

Go ahead and laugh. It's true.

What? That the government is to blame b/c they made it too tempting for companies to cheat and over-bill medicare by ordering unnecessary test as a part of procedure?

As long as it's illegal for hospitals to turn away patients based on their ability to pay, government is going to be involved. (and you know that's not happening anytime soon) We ALREADY have universal health care and have had it for decades. The only question now is how to be as efficient as possible.






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cwill
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re: CBS devastates HMA on 60 Minutes ==> "Hospitals: The cost of admission"


quote:

The only question now is how to be as efficient as possible.


And this won't happen with government involved and expect healthcare to cost the maximum possible under any gov't program....Also expect more fraud where gov't is running the show....in fact bank on it.






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Taxing Authority
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re: CBS devastates HMA on 60 Minutes ==> "Hospitals: The cost of admission"


quote:

We ALREADY have universal health care and have had it for decades. The only question now is how to be as efficient as possible.
Why would it be the only question? If... As you suggest... Providing unpaid universal healthcare is whats driving up costs, why not work to reverse the cause?



This post was edited on 12/3 at 3:30 pm


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a want
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re: CBS devastates HMA on 60 Minutes ==> "Hospitals: The cost of admission"


quote:

Providing unpaid universal healthcare is whats driving up costs, why not work to reverse the cause?

Like how? I'm all ears.






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Diamondawg
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re: CBS devastates HMA on 60 Minutes ==> "Hospitals: The cost of admission"


quote:

As long as it's illegal for hospitals to turn away patients based on their ability to pay,
It is not illegal. Walk into a business office of a hospital and tell them you have no insurance but would like to have a cholecystectomy and see how long before you get a room.
quote:

We ALREADY have universal health care and have had it for decades.
Me thinks someone doesn't know what universal health care is.






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DeltaDoc
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re: CBS devastates HMA on 60 Minutes ==> "Hospitals: The cost of admission"


quote:

quote: Providing unpaid universal healthcare is whats driving up costs, why not work to reverse the cause? Like how? I'm all ears


Not by coincidence, many of those that do not have health insurance also have very poor eating habits...many these same people also receive welfare and food stamps.

As such, one way to make people healthier and reduce the necessity of healthcare...often very expensive and long term treatment...should be to severely restrict what foods can be purchased with food stamps and/or welfare money.

No soft drinks can be purchased. No sweets can be purchased. Foods high in salt content are very limited. Foods high in fat need to be severely limited.

My view is that if you depend on the government for your food, you necessarily lose your freedom to eat as you wish.

I am not so sure I would not actually set up government markets for food stamp recipients and prohibit the use of food stamps outside of these markets to ensure what is being purchased is healthy.

I think the off-set in setting up these markets with lower health care costs would more than pay for itself and result in a healthier population.






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Bard
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re: CBS devastates HMA on 60 Minutes ==> "Hospitals: The cost of admission"





This post was edited on 12/3 at 3:58 pm


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a want
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re: CBS devastates HMA on 60 Minutes ==> "Hospitals: The cost of admission"


I have no problem with that. I think it's politically impossible, but I agree with you.





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a want
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re: CBS devastates HMA on 60 Minutes ==> "Hospitals: The cost of admission"


quote:

It is not illegal. Walk into a business office of a hospital and tell them you have no insurance but would like to have a cholecystectomy and see how long before you get a room.

Right. But they wait until they colon cancer - then they go in a receive free treatment.






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DeltaDoc
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re: CBS devastates HMA on 60 Minutes ==> "Hospitals: The cost of admission"


quote:

I think it's politically impossible


It is politically impossible as long as we have parties that pander to the votes of these individuals.

I suppose my point of view on this topic may look cold and heartless. I recognize there are millions that have grown up knowing nothing different than food stamps and welfare and ding dongs for breakfast. There is a reasonable argument that they literally don't know better as a result.

I actually think it is more cold and heartless not to intervene on behalf of these people to break the cycle.

I firmly believe it would only take one generation to break the cycle relative to poor eating. However, these people are not going to do it own their own.






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NC_Tigah
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re: CBS devastates HMA on 60 Minutes ==> "Hospitals: The cost of admission"


quote:

What? That the government is to blame b/c they made it too tempting for companies to cheat
a want, CMS (the government) is the most intrusive, inefficient, disorganized payer in American Healthcare.

In terms of cheating, CMS' presupposition is that if EVERYone has to jump through audit threats and bureaucratic hoops the system will be clean. They have a history of randomly selecting audits that cost totally innocent providers and facilities hundreds of hours in work-product and significant cash outlay. This is done literally at the same time whistle-blowers are registering complaints about groups or individuals suspected of ripping CMS off. Incredibly, those complaints often go totally unattended to . . . . as was almost assuredly the case with HMA.

That's our government at work. Kind of like TSA feeling-up randomly screened 4y/o girls at the airport, while a groups of burka clad adults pass through unfettered.

CMS is absolutely to blame for not not picking up this BS.

They suck at what they do!






This post was edited on 12/3 at 4:06 pm


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Taxing Authority
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re: CBS devastates HMA on 60 Minutes ==> "Hospitals: The cost of admission"


quote:

Like how? I'm all ears.
If "free" care is driving up costs... the best way to stop driving up costs it so eliminate "free" care. It really isn't complicated.

No pay no care. Simple. Just like every other product and service you need.

As it is now... what incentive does one have to properly plan for and pay for their care? Little. Why pay for something you can get for "free".

Sadly Obamacare only makes this situation worse. Why even have insurance? The "tax" penalty is 10X less than premiums are. And insurance companies can't charge you more (or deny) you coverage for pre-existing conditions. Economically, why not just wait until you need care. No reason to save. No reason to plan. No reason to take any responsibility for yourself. Just let *someone else* pay when the time comes.

Until we get back to pay-for-our-own care --expect costs to continue up.

The OP is a great example of how third-party payor drives UP costs. Because the patient doesn't give a crap about the cost. The doctor doesn't give a crap about the cost. And the payor isn't in the loop to make any reasoned decision about the necessity until long after the services are already performed.

You can bet you azz if the patients in the OP were paying with their own cash the question "Is all this really necessary" would have been asked.



This post was edited on 12/3 at 4:12 pm


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