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Hospital Chain’s Revenue Strategy Puts Patients at Risk

Health Management Associates has been named in eight lawsuits alleging the for-profit hospital has been increasing revenue by admitting more patients—whether they needed inpatient care or not—resulting in unnecessary tests and other procedures. This bizarre quota system, with a goal of admitting at least half of all patients over 65 who visited the emergency room, was purportedly designed to defraud Medicare and Medicaid.

While this dubious scheme is chilling on its own merits, the patients involved may have suffered economic setbacks or even been subjected to dangerous conditions.

Each year, thousands of patients suffer harm due to avoidable mistakes, known as preventative adverse events (PAE). While many potential risks are associated with surgical procedures, such as post-op bleeding or anesthesia complications, just being admitted to a hospital carries some amount of risk.

Nosocomial Infections, also known Healthcare-Associated Infections (HAIs), are infections that patients acquire while receiving healthcare for other conditions. According to the Centers for Disease Control and Prevention (CDC), “In 2002, the estimated number of HAIs in U.S. hospitals, adjusted to include federal facilities, was approximately 1.7 million: 33,269 HAIs among newborns in high-risk nurseries; 19,059 among newborns in well-baby nurseries; 417,946 among adults and children in intensive care units (ICUs); and 1,266,851 among adults and children outside of ICUs.”

Older patients and those with weakened immune systems are especially susceptible to HAIs, which may include tuberculosis, septicemia, endocarditis, meningitis, hepatitis, hospital-acquired pneumonia, and illness due to antibiotic-resistant bacteria such as MRSA.


Source: “Hospital Chain Said to Scheme to Inflate Bills” by Julie Creswell and Reed Abelson, New York Times, January 23, 2014.