A detailed look at Hospital Corporation of America (HCA) and how its business practices have come under scrutiny as it has become more profitable. A bit lengthy, and highlights the strengths of private sector management practices as well as some of the pitfalls of ‘gaming’ reimbursement systems and implications for patient care. A cautionary tale to Atul Gawande’s Can Hospital Chains Improve the Medical Industry? : The New Yorker; but he does note the need for strong regulatory oversight.
Among the secrets to HCA’s success: It figured out how to get more revenue from private insurance companies, patients and Medicare by billing much more aggressively for its services than ever before; it found ways to reduce emergency room overcrowding and expenses; and it experimented with new ways to reduce the cost of its medical staff, a move that sometimes led to conflicts with doctors and nurses over concerns about patient care.
And some further comment by a former hospital executive (Not Running a Hospital blog), indicating the further pitfalls of the HCA model: