A comparison was done with using big hospital chain Tenet, who admitted 39% of the ER patients while the stats at Prime were 63%, so that’s pretty big difference with just looking at the percentage numbers.  Back in February of this year, Prime imagewas also questioned about some of their billing processes with a large number of Medicare patients showing malnutrition.  I live in the OC and remember the hospitals from a business standpoint before their acquisitions and they were busy but now when you drive by the hospitals you can roll bowling balls through the parking lots that were once crowded and challenging to find a parking space. 

Prime Healthcare Billing Processes Under Question as 25% of Medicare Patients are Showing Malnutrition- Profit Algorithms?

A few months ago Prime Healthcare bought another hospital in San Diego where I commented about another Cadillac ER on the way, as this is where the money is with healthcare with current laws and regulations. 

Alvarado Hospital Recently Acquired by Prime Healthcare To Lay Off One Quarter of the Staff in San Diego

As mentioned above when purchased, it kind of looks like the services that are not profitable are abolished and again you see big vacant parking lots at patients have to go elsewhere.  How does this balance out if all hospitals were to run strictly on profit?  Prime also buys hospitals that are usually in financial straits and thus the pricing I think has been what they chain is willing to pay, but in some instances if Prime didn’t buy them, the hospital would close so 6 of one and half a dozen of another.  image

I read the other day to where Prime has filed suit against the consumer group investigating and reporting on the deficiencies they are finding with the chain.  Kaiser has had issues with the chain for a few years now and the new issue at hand is the fact that patients are being “held hostage” for ER admittance, in other words somewhat coerced into being admitted at Prime instead of going to another hospital to be admitted and perhaps one in network. 

“The chain’s founder and board chairman, Dr. Prem Reddy, once described the emergency room as a “gold mine” of Medicare and Kaiser patients, according to the former medical director of Desert Valley Hospital in Victorville.”

Prime HealthCare and Kaiser Still Duking it Out In Court – Patients are Off the Hook for the Balance Due Bills

The comments go on to say that Prime did not want to miss an opportunity to admit a fully insured patient when the opportunity was there and most hospitals of course like to get paid as any other business but the questions here arise about Prime maybe over stepping their coding and ER admittance procedures.  This will be an interesting case to follow to see how the analytics and numbers all shake out.  BD 

A Southern California hospital chain has boosted its profits by transferring an unusually high number of patients from its emergency rooms to its hospital beds, gaining hundreds of millions of dollars by targeting people with Medicare, a California Watch investigation has found.

Patients and their families have described feeling trapped by doctors and administrators working at Prime Healthcare Services facilities. They entered the emergency room and were stuck in a "Twilight Zone," as one family member described it, unable to see their own doctor at another facility or faced with treatment that seemed unnecessary.

During a 2006 Orange County Board of Supervisors hearing, Dr. Abdul Khan, a doctor at Huntington Beach Hospital, said that after Prime took over that year, doctors were told to admit insured patients who arrive in the emergency room with maladies as minor as a headache. 

In late 2006, Prime took over hospitals in Anaheim, Huntington Beach and La Palma. The chain took over a Garden Grove hospital in mid-2008. By 2009, those hospitals, on average, admitted 64 percent of Medicare patients to hospital beds – compared with the 44 percent admission rate at those same hospitals in 2005.

More than a dozen other Orange County hospitals also admitted about 45 percent of Medicare patients in 2009.

How Prime Healthcare chain boosted hospital admissions | prime, patients, hospital - News - The Orange County Register

3 comments :

  1. It si amazing how Prime is criticize for admitting kaiser patient and/or patients with insurance, but you don't criticize the fact that the sharp hospital as well as kaiser would go on bypass for all uninsured patient but will tell the EMS to bring their insured pts to their facility even when most of the time they wait on the EMS gurneys for hours. How I know this,will I personally attend these so call county meeting and this is the kind of discussion they have. They claim is for the best of the patient, because they have their medical records available. I call it EMTALA VIOLATION. When you go on diversion it is because your ER Is unsafe to receive any patient. But kaiser and sharp pick and choose who they want to see.. It's about time someone investigate this, don't you think? If Prime was the only company seeing pts based on insurance, the US would be safe.. But there are other facilities that are doing worse, and your focus is only on a small business that is actually practicing better standard of care than any other facility.

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  2. Hi, I have to make a comment about Prime healthcare. I am a mother of a son that had meningiococal meningitis at the age of 4 months. I almost lost my son because I was a medical insurance case and no physician wanted to take my case. I became a nurse after my son illness to help mothers with similar cases like mine, and will never tolerate physicians not to admit or provide care to any patients because of their insurances. That is why I work for many years for Prime healthcare. I am today a director of one of Prime's hospital ER and I am proud of being part of this organization.. To all prime employees and physicians, thank you, for your caring and companion giving to all patients everyday. Stay strong we are talked about because we have made a difference in the healthcare industry, and people don't take the time to embrace us. They do what easier and more common to them, they look for faults. I have experience what you might call discrimination due to insurance, and I have found in Prime, to be an organization that provides care with companion regardless of insurances. I am a proud Prime NURSE.

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  3. I agree! Kaiser and other facilities, invest money in buildings, applications and bribes!! They are the reason why US is in its worst shape today.

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