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December 10, 2008

BehindTheMedspeak: Healthcare credit score — just another name for wallet biopsy

Doctor_patient_relationship

Certainly it's more politically correct but they're exactly the same thing.

First I'd ever heard of a healthcare credit score was when I read Sarah Rubenstein's eye-opening piece in today's Wall Street Journal.

Long story short: "Some patient advocates worry that credit data can be used by hospitals to deny or cut back treatment or to disqualify people from financial assistance.... The health credit score isn't used to deny or approve treatment, the company says."

Right.

And when the studies show the outcome is only marginally better for a neurosurgical procedure done on an emergency basis than simply watching and waiting to see if the patient dies, you know they'll be taking that individual right into surgery regardless of whether they're carrying first-class health insurance or on Medicaid.

Gimme a break.

Here's the WSJ article.

    Experian to Add Work For Hospitals

    Credit-reporting bureau Experian PLC said it agreed to acquire SearchAmerica Inc., a closely held company in the business of mining patients' financial data to help hospitals determine how likely patients are to pay their medical bills.

    With the $90 million purchase, Dublin-based Experian is getting heavily involved in health care at a time when hospitals are struggling to collect from both the uninsured and underinsured. Equifax Inc. and TransUnion LLC, credit-reporting bureaus based in the U.S., also offer services that help hospitals get a sense of patients' incomes and payment likelihood.

    "Hospitals are trying to become more sophisticated in managing their cash flow and their revenue cycle," said Kerry Williams, Experian's group president of credit services and decision analytics. "Health-care costs are rising and U.S. employers continue to put more and more of the payment of health care on to the employee."

    SearchAmerica, based in Maple Grove, Minn., uses financial data collected by credit bureaus to help hospitals determine whether patients registering for treatment will qualify for financial-assistance programs such as Medicaid or charity care. The company also generates a health-care credit score and helps hospitals figure out who has the means to pay and who should be pursued most actively for payment after patients receive care.

    Some patient advocates worry that credit data can be used by hospitals to deny or cut back treatment or to disqualify people from financial assistance. "I have found many hospitals making people jump through all sorts of hoops to try to get them knocked out of the financial-assistance category that they deserve to be in," said Alan Alop, deputy director of the Legal Assistance Foundation of Metropolitan Chicago.

    But SearchAmerica, which has 50 employees, says the purpose of its services is to efficiently qualify patients for financial assistance. The health credit score isn't used to deny or approve treatment, the company says.

    SearchAmerica's client base includes about 200 health systems, many of which own more than one hospital.

.....................

More?

OK.

Here's Rubenstein's blog post about on the subject, just up at 10:09 a.m. today.

    Hospitals Tap Credit Bureaus to Gauge Patients’ Ability to Pay

    There’s new momentum behind hospitals’ efforts to predict how likely patients are to pay their medical bills.

    Experian, one of the three major credit bureaus, has agreed to acquire SearchAmerica, a small company that’s in the business of mining patients’ financial data, the WSJ reports.

    SearchAmerica uses data collected by credit bureaus — from payment histories to credit limits — to gauge patients’ incomes and payment habits. As we explained earlier this year, SearchAmerica and others in the business says their goal is to help hospitals more efficiently assess patients for financial assistance, and to prioritize collections for patients who are most able to pay.

    “SearchAmerica’s software simply makes the process of getting folks into financial assistance programs more efficient and more accurate,” Dan Johnson, SearchAmerica’s CEO, told us. Equifax and TransUnion, the two other major credit bureaus, also offer services that help hospitals get financial profiles of patients.

    Experian says the data aren’t used to deny or approve care. But the area is controversial, as evidenced by a recent piece in BusinessWeek that shows patients in tough straits who had trouble getting help from hospitals with info about their finances.

    “I have found many hospitals making people jump through all sorts of hoops to try to get them knocked out of the financial-assistance category that they deserve to be in,” Alan Alop, deputy director of the Legal Assistance Foundation of Metropolitan Chicago, told the WSJ.

...................

Looks like the WSJ is on the same page as me: witness the graphic (below)

Wer5aypoi

it used to accompany the blog post above.

The only thing missing is the biopsy needle.

December 10, 2008 at 12:01 PM | Permalink


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Comments

This is insane.

Posted by: Elisa@Thrive | Dec 11, 2008 3:15:04 PM

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