WhiteCoat

Pressure to Admit

We were away for the weekend, but in a restaurant, I caught glimpses of this segment on 60 Minutes called “The Cost of Admission.” Couldn’t hear the conversations in the restaurant, but luckily CBS posted the entire report online. If you didn’t see it, you really need to watch the video and/or read the transcript.

In summary, 60 Minutes spent a year investigating irregularities in hospital admissions. Administrators at Health Management Associates and at EMCARE (one of the national emergency medicine contract groups) were accused of putting pressure on emergency physicians to admit at least 20% of patients that came to hospital emergency departments.  For Medicare patients, the “benchmark” for admissions at one hospital was allegedly 50%. The 60 Minutes expose also included spreadsheets showing comparisons of different physicians’ admission practices and text from e-mails saying such things as “I have been told to replace you if your numbers do not improve.”

HMA held a conference call disputing the allegations and stating that they “take all allegations regarding compliance very seriously.” HMA allegedly had outside experts review the data (not the medical records?) and the experts determined that “the data simply do not support the allegations.”

Now HMA is being investigated by the US Department of Justice for Medicare fraud. I predict that HMA will make a large settlement with the government to drop all charges (without admitting wrongdoing, of course) and that things will return to business as usual shortly thereafter.

With things like this, I can’t really blame patients for thinking that medical care is “all about the Benjamins.”

Patient satisfaction metrics are creating quite similar incentives with physicians. How long will it be before people wake up and see how much fraud that the satisfaction scores are causing?

2 Responses to “Pressure to Admit”

  1. Retired because of this kind of crap. says:

    And in a similar vein is this much older 60 MINUTES report on emergency medicine:
    http://www.cbsnews.com/8301-504803_162-57556625-10391709/1993-mike-wallace-reports-on-er-docs/

  2. [...] which drives up the number of medicare and medicaid reimbursements to hospitals. This can be seen here, in White Coat’s blog at the Emergency Physicians Monthly Journal. There is healthcare fraud [...]

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