HCA Coding Methods Invigorate Profits. This is Bad?
Here's the gist, according to the Times:
"In late 2008, for instance, HCA changed the billing codes it assigned to sick and injured patients who came into the emergency rooms. Almost overnight, the numbers of patients who HCA said needed more care, which would be paid for at significantly higher levels by Medicare, surged."
The way those two sentences read suggests that the hospital chain was up to something nefarious.
Now, I'm no defender of the sometimes-sordid way this corporation has conducted business over its long history. The $1.7 billion in fines paid to the government for tactics that took place under the leadership of former CEO and now Florida Gov. Rick Scott remains a giant black mark on its reputation.
Though legal, books and business school case studies could be written about the way HCA has used complex financial engineering to weave the company in and out of public ownership, meanwhile vastly enriching insiders as well as those who supplied it equity to undertake this bobbing and weaving business strategy.
But back to the billing and coding changes. What seems to have happened, at least on a grand scale, is that HCA got smart about how to better manage its ED and to better document the work its clinicians are doing on patients. On its face, what's wrong with that?
- New G-Codes to Pay Doctors for Broad Array of Non-Face-to-Face Care
- CMS Sets 2014 Pay Rates for Hospital Outpatient and Physician Services
- States Rejecting Medicaid Expansion Forgo Billions in Federal Funds
- Douglas Hawthorne—A Chance to Do Something Big
- Telehealth Improves Patient Care in ICUs
- Why You Should Involve Patients in Nursing Handoffs
- Hospital M&A Volume Up, Value Down in 3Q
- Not-for-Profit Hospitals Find Opportunity Amid Uncertainty
- The 5 Biggest Healthcare Finance Trouble Spots
- 50 Years of Fighting Pressure Ulcers Called Into Question