Maybe this is something worth discussing as it certainly exists out there and since I cover many areas of imagehealthcare, I’m seeing more and more of this with one hospital system doing very well, like UPMC, a non profit with a billion a year in excess revenue (that is profit talk for non profits) and then others struggling.  So much of the time we see news articles that state the ones having problems “don’t operate efficiently” and while there may be some truth to some of that, the divide here is growing all the time and that can’t be the only reason for the disparity.  Health IT can’t solve it all or even work at all in some areas to where the cards dealt vary so much.  Below you can read about the City of Pittsburgh suing UPMC as they could use some of that money.  Again you may have real estate that gets sold, you have to look at the demographic areas the hospitals serve and last but not least, reimbursement as that can be all over the place. 

Legal Battle With City of Pittsburgh and UPMC Medical Center Heating Up Again–Non Profit Hospital Pays No Property Taxes & Gets $200 Million Dollar Tax Break With $1 Billion in Excess Profits

Some hospitals have better assets to offset some of the reimbursement issues that are pretty much on the rise everywhere and sometimes I think some hospitals too get brow beaten over the fact that they can’t make money when in fact it’s the cards they were dealt to begin with.   Some may not have assets to fall back on and some don’t have money to keep up with enough IT investments and yet they are in the same CMS arena to perform the same with what they do.  Sure there are some adjustments out there and some of those help out for sure with non profits in particular but some get outdate too and as economic times change, they don’t work as well, or if the verbiage in the law gets interpreted with “selected context” some get windfalls too.  We don’t see the latter too often by comparison, but it’s out there.

Just yesterday I wrote about an abrupt close of a hospital in Massachusetts that closed on Friday and even the Governor was powerless to do a thing as they were flat out of money.  We they doing things so badly efficiency wise that they were a “bad hospital” without enough technology?  I don’t think so and again go back to the demographic areas they serve and look at the reimbursement issues the hospital was having. 

North Adams Hospital In Massachusetts Closes Abruptly on Friday, Out Of Money & Court Order To Stay Open Seems To Be Trumped By Lack of Money & Plan To Save The Hospital

Sometimes in the non profit areas you do see one hospital helping another and I go back a few years ago with Kaiser Permanente sending money to Grady Hospital in Atlanta, which was great but again they have to watch their own business and can’t be on the hook to save all hospitals either.  That was at a time when other hospitals in Atlanta said we would like to help but have our own problems. 

A couple months ago, 6 hospitals went up for sale here in California as they were out of money and it barely made the news.  Again are we going to do the same “shame” story here again and blame management for all of it when in fact there were many issues that lead to this?  It seems to be what you read anymore with folks searching for a simple reason for this re-occurrence that keeps happening?  It is time to stop to stop beating that drum and do some better in depth studies as to why this keeps repeating itself? 

Hospitals Feeling The ACA Crunch In California As Financially Strapped Daughters of Charity Health System Put Six Hospitals Up For Sale

Another contrast here in Los Angeles with Cedar Sinai, they seem to have quite a bit of money to keep up buying up physician practices as one doctor recently stated “they made me an offer I couldn’t refuse at it was that good”.  We know the reason for this type of activity comes back to reimbursement again as they can charge more to Medicare and some insurers when a patient is treated at a hospital owned facility and they are not by far the only hospital doing this.  The uneven levels of excess profits are not just limited to non profits either, here’s one example..

Hospital Profits and Revenue All Over the Place–Tenet Shows $28 Million While a Non Profit UPMC in Pennsylvania Has Excess Revenues of a Billion a Year & Hospital Revenue Cycling Subsidiaries Compete With Those Owned And Operated by Insurance Company Subsidiaries…

So this being said, we now have issues like this with either doctors or hospitals wanting to help patients with their insurance premiums and the logic behind this is not hard to figure out the ROI as if they help keep a patient insured it’s going to cut the losses the doctor or hospital has to absorb and the patient gets the care with reimbursement from the insurance company.  Sure I see the discussion here as to “which” patients will get this kind of help but I would rather see that and at least some patients get the care they need rather than it not take place. 

Hospitals Could End Up Paying Insurance Premiums With Consumer Policies Bought Through Exchanges If Patients Fall Under Major Income Stress Leading to Payment Default

As I have said, Obamacare and all of healthcare really for that matter is a big Attack of the Killer Algorithms..those damn algorithms can bring everything to a stop for sure until decisions are made about how they should work.

When Doctors Give Patients Money, Hospitals Pay Patient Insurance Premiums, Humans Helping Other Humans As The Attacks of the Killer Algorithms Grow Stronger Everyday While Gov Can’t or Won’t Model Or Wake Up For That Matter…

Now when this comes up for discussion we have the politicians getting involved with discussion that will probably just go nowhere for now at least.  With consolidation of hospitals today charges don’t seem to be going down at all and consumers with our inequality issues can bear the burden.  You can read the post below how the two individuals here who are largely both caught up in the Sebelius Syndrome overall are going to talk about this…so how do make a law on this topic?  That’s a really good question as you will end up denying care where it could be possible for patients. 

Senator Grassley and Kathleen Sebelius Duking It Out Over Hospitals Paying Patient Premiums–A Case of One “Who Believes In Algorithm Fairies” Talking To Another…

Long and short here is the failure of quite a few models here and why it is important to model in the hopes of catching a lot of unintended consequences before they occur and you will never catch all of them but if you see some ahead of time it does help.  Politicians tend to just suck in anything they read at times and we end up with quantitated justifications for things that are not true, and again this comes back to “those measurement” we see on hospitals all the time that are supposed to be care and safety related, but we certainly can’t fool ourselves and say that money has no part here, because it does. 

Quantitated Justification For Believing Things That Are Not True And Using Mathematical Processes To Fool Ourselves-The Journalistic Bot Functionality Debuts As Media Can’t Resist the Formulas

So there you go perhaps a new topic to begin giving attention, “Inequality for Hospitals” as it does exist and how long before we really start taking a look?  So far inequality for consumers has been talked about but that’s about it as politicians refuse or lack the intelligence to see how all of this is modeled.  It’s all math models and subsequent algorithmic processes running on servers 24/7 whether it’s consumers or hospitals that keep the inequality movement growing sadly. 

You can explore more of this in the financial world here with a collection of links and videos that talk about Algo Duping and the Attacks of the Killer Algorithms provided by people smarter than me that have taken time for several years now to educate and give the warning and when politicians decide to come into the “real” world from their virtual perceptions, who knows.  That is also a big problem as well as I recently discussed that topic at the link below too.   

Virtual Worlds, Real World We Have A Problem And It’s A Big One With A Lot of Gray Areas Finding Where The Defining Lines Exist, Confusing Many With A Lot of Weird Values And Strange Perceptions…

Inequality is all “modeled” using a lot of segmentation in short…watch video # 3 in footer for more on this topic.  BD

Modeling for Inequality With Segmentation, Insurance Industry Uses Backwards Segmentation As Some Models Stand to Threaten Overall Democracy


  1. Many thanks for the amazing essay I really gained a lot of info. That I was searching for