PS - The New York Times article mentioned above cited a health care corporation called Health Management Associates (HMA) for pressuring doctors to admit patients to hospitals:
"At the very same time that many independent physicians are struggling just to remain in private practice due to increased office expenses and declining reimbursements, large hospital entities--under the guise that bigger is better and cheaper--have been incentivized to gobble up those physician practices and become true monoliths in our health care system. But what a shocker! This consolidation, to no one's surprise but to the chagrin of many, demonstrates that not only is bigger not better, it isn't cheaper , either!"
"What a colossal shame for patients (and payers) that physicians were not accorded the same incentives to save their practices. With independent physicians, and unlike those consolidators, there is no question about loyalties to the patient or advocacy issues. And as the spokesperson for the FTC's Bureau of Competition stated: "Historically, what we've seen with the consolidation in the health care industry is that prices go up, but quality does not improve." How sad that neither patients nor physicians had any say in this evolution. Perhaps the worst impact of consolidation on the patient: unless there are new incentives developed quickly to help physicians, say goodbye to the private practice of medicine."
Lou Goodman, PhD, President, The Physicians Foundation, Tim Norbeck, CEO, The Physicians Foundation
PPS - Following closely on the heels of the New York Times article came a December 2 CBS "60 Minutes" report titled "The Cost of Admission." In essence, the report was an expose on the business practices of Health Management Associates (HMA), a corporation with $5.8 billion of revenues that owns 70 hospitals, mostly in nonurban areas. Three doctors, an administrator, and a former FBI agent who worked for HMA testfied that the corporation pressured ER doctors to meet admission qoutas of 20% overall and 50% for Medicare patients. Further, they maintained, the company had installed a software program in every ER called Pro-Med that automatially ordered a battery of laboratory tests, whether the tests were requested by a physician or not. Doctors who did not meet admission quotas were threatened with firing. The motivation for inappropriate hospital admissions, according to those who appeared in 60 minutes, was money - not quality of care, but quantity of care. A Health Management Associates executive denied the allegations, which are being investigated by the Justice Department..
Tweet: To comply with government regulations, hospitals and doctors are consolidating. The result may be increased costs and market monopolies.