Bayonne Medical Center wasn't just bragging about efficiency when it posted a big digital clock on a highway billboard a few years ago to show the real-time waits in its emergency room. It wanted patients to come to its ER. Lots of patients. It didn't matter if the hospital was in the patient's insurance network. On the contrary, to the businessmen who had recently purchased the medical center, those "out-of-network" patients held the key to reversing Bayonne's fortunes. These owners, who bought the hospital in bankruptcy, had found an unintended — and very profitable — consequence to a state regulation that was designed to protect patients with urgent medical needs.