Friday, February 23, 2018
Editorials

Editorial: HCA is case study in trauma center greed

Memo to the Florida Legislature: This is not the year to open the gates for more trauma centers. This is the year to stand against runaway medical costs and force existing trauma centers — particularly those operated by the Hospital Corporation of America — to justify the often exorbitant charges they bill patients. Practices that amount to price-gouging have no place in a state-regulated industry.

A yearlong, unprecedented analysis by the Tampa Bay Times' Alexandra Zayas and Letitia Stein has unmasked the greedy reality that many Florida hospitals are using trauma charges to pad the bottom line. The most obvious mechanism: A so-called trauma center response fee, designed to help defray the costs of a trauma center's extensive staffing and infrastructure, has risen from an average of $2,555 just seven years ago to $10,800.

Even those numbers don't tell the full story of how one of the nation's largest for-profit hospital chains is largely responsible for that trend, charging response fees as high as $33,000 and emboldening others in the industry to increase prices. No other hospital company in Florida has exploited the lack of transparency and regulation in trauma center pricing as well as HCA. The company has raised the cost of care in communities where they have opened six trauma facilities in the past five years.

Zayas and Stein found that four HCA trauma facilities are among the top five most expensive in the state when it comes to average patient bills — including two that are more expensive than No. 3 Tampa General Hospital, which as a Level 1 trauma center offers a fuller complement of services. All of HCA's facilities are Level 2.

What hospitals charge, of course, is often higher than what they recoup from patients, insurance companies or government programs (Medicare will pay only $1,000 for a trauma center response fee). But the Times investigation found that in at least two cases, HCA has negotiated such sweet reimbursement deals with private insurance companies for all its trauma charges that Florida Blue, the state's largest private insurer, had been paying HCA twice as much on average as it pays other trauma centers. Humana, another major insurer, was paying as much as four times more per patient than it paid other hospitals. That has real consequences for anyone who pays private insurance premiums.

No wonder HCA has been so bullish on opening trauma centers in Florida, seeking political help from friends in the Legislature and provoking legal challenges. Senate health care appropriations chairwoman Denise Grimsley, R-Sebring, is pushing legislation, SB 1276, that would protect the last three trauma centers HCA opened — including Regional Medical Center Bayonet Point in Pasco County — against legal challenges from nearby hospitals. Grimsley's plan also would give HCA the opportunity to open more trauma centers in the future.

Florida should not establish health care policy that encourages practices that exploit the most vulnerable of patients. Trauma patients cannot choose which hospital they're taken to, and the luck of the draw shouldn't mean a difference of tens of thousands of dollars in costs. House Speaker Will Weatherford, R-Wesley Chapel, and Senate President Don Gaetz, R-Niceville, should send a clear signal that Florida won't tolerate such exploitation. The Legislature should regulate trauma center charges. It's got 53 more days this legislative session to get it done.

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