Some HCA doctors don't care for the screening practice, which encourages non-urgent patients to go to free clinics or to pay copayments or fees before services can be rendered.
HCA's approach parallels a goal of healthcare reform, to keep people out of the ED to help reduce healthcare costs. The government is doing this by encouraging patients to get preventive care and to see primary care physicians. HCA took more of a sledgehammer approach.
Although HCA's approach is distasteful to some, it has not been found to be a violation of the Emergency Medical Treatment and Labor Act. Keep in mind that patients at primary care offices are asked to pay co-pays upfront, and essentially non-urgent care is like primary care.
Moreover, many hospitals are now analyzing patients' high-deductible health plans to determine the patient's upfront payment before care. So was HCA out of step, or did it just take the step too early? Similar ED triaging strategies are now proving to be ED time- and money-savers, as several hospitals are demonstrating.
The New York Times article says that HCA doctors and nurses felt strained over "whether the chain's pursuit of profit may have, at times, come at the expense of patient care." I'm certain their sentiments are true, but are there any healthcare CFOs that haven't heard similar comments from clinicians? The fact is, the clinical and financial sides of healthcare often butt heads—yet one cannot succeed without the other.