When individuals in New York seek medical attention, they expect a certain level of professionalism and care. Even when entering a busy emergency room, residents expect that doctors and other staff will attempt to make the best possible decisions for the situation at hand. A lawsuit filed across six states against one of the top hospital chains in the country brings to light the fact that financially based decision making sometimes supersedes patient needs. It also raises the question: When patients are needlessly admitted or treated to bolster financial numbers, does it increase the chance of hospital negligence through exposure to hazards and possible medical mistakes?
According to an attorney representing whistleblowers in the case, doctors at facilities in the Health Management Associates chain felt pressured to increase admission rates. Strategies were specifically created to increase the number and amount of charges facilities billed to Medicare and Medicaid. In one instance, an infant was allegedly admitted to a hospital for treatment of fever, even though the baby presented with a temperature of 98.7 degrees.
Whistleblowers allegedly reported a scorecard practice in one emergency room. Each day, according to reports, doctors’ names were put up for all to view with a score card color indicating performance. The performance metric being measured was whether or not the physicians admitted at least half of the people who presented to the emergency room who were also 65 years old or older. According to whistleblowers, the push to increase admissions had nothing to do with patient care.
There are eight lawsuits pending against HMA for similar claims. HMA is currently in the process of purchasing Community Health Systems. The combined company would become the nation’s largest for-profit hospital chain when measured by revenue. According to reports, the allegations of possible fraud and inappropriate patient admissions have not seriously impacted the acquisition or the stock price of the company.
Reports are that this type of financially driven strategy is not unique to HMA. When individuals are improperly admitted and treated, they have a right to seek compensation for medical expenses. If an inappropriate hospital stay results in injury, then individuals may be able to sue for damages including pain and suffering, expenses and loss of wages.
Source: News Telegram, "Lawsuits claim hospital chain schemed to inflate bills" Julie Creswell, Jan. 24, 2014