1. Health

Having a heart attack? HCA hospitals hope you'll think of them

An HCA Healthcare mailer advises people having a heart attack to tell EMS to go to an HCA Pinellas County hospital.
An HCA Healthcare mailer advises people having a heart attack to tell EMS to go to an HCA Pinellas County hospital.
Published Aug. 18, 2014

Having a heart attack in Pinellas County? HCA Healthcare, the nation's largest for-profit hospital chain, is making a pitch it hopes you'll remember in a time of emergency.

"Make the seconds count," the company's west Florida division says in a recent mailing to households. "Call 911 and ask EMS to take you to an HCA Pinellas County Hospital."

Marketing emergency departments can be a tricky strategy, but it's one that HCA has embraced perhaps more than any other Tampa Bay area hospital group.

The Nashville-based company, which three years ago launched a massive marketing campaign for its emergency departments in Florida and several other states, advertises patient wait times at its facilities on billboards along the region's busiest roads. Florida Hospital, part of the nonprofit Adventist Health System, has also turned up the ER marketing heat, some of its Tampa billboards located not far from HCA's.

HCA's latest mailers, however, go beyond wait time. The company says it's using the mailers just to let Pinellas residents know its five hospitals in the county are well-equipped to handle the deadliest heart attacks. Spokeswoman J.C. Sadler cited the HCA's hospitals accreditation as chest pain centers, as well as their performances on quality measures related to timely heart attack care.

"We are confident that patients who request to be taken to an HCA hospital will be given outstanding care," she said.

But the message raises questions of whether it could encourage patients to make a choice that leads to a delay in care.

The mailer, for instance, was sent to one Clearwater home that is closer to two BayCare Health System hospitals with specialized care for heart attack patients — Morton Plant (5.8 miles) and Mease Countryside (6.1 miles).

The closest HCA hospital with specialized care is Largo Medical Center — 8.2 miles away.

Early treatment for the deadliest type of heart attacks, known by its acronym STEMI, minimizes damage to the heart muscles and increases the chances of survivability. Dr. Howard Mell, a spokesman for the American College of Emergency Physicians, said the worst-case scenario would be for such a patient to insist on a particular hospital even when capable facilities are closer.

"You really want to be at the closest appropriate place," he said. "Minutes matter."

In Pinellas County, critical patients are rushed to the closest hospital regardless of preference, said EMS director Craig Hare.

Stable patients can choose their hospital if it is within 30 minutes of the scene, though paramedics recommend the closest hospitals with specialized services for STEMI patients, such as balloon angioplasty.

That EMS list of specialized cardiac services includes HCA's Largo Medical Center and Northside Hospital, though not its Edward White Hospital, St. Petersburg General Hospital or Palms of Pasadena.

Promoting ER services can be difficult. Patients aren't typically shopping for one until they need it. And some critics have complained that promoting the ER — either by advertising wait times or accepting online appointments — can crowd hospitals with patients who don't have an emergency.

Medicaid officials in Washington state several years ago, for instance, issued new rules making it harder for hospitals to qualify for Medicaid bonus payments if they promote their ER for primary care, according to the Washington Post.

It's unclear what impact HCA's marketing has on its emergency room business. In Pinellas County last year, the four emergency rooms with the most patient visits were Morton Plant Hospital (62,965), Mease Countryside (42,710) All Children's Hospital Johns Hopkins Medicine (41,903) and St. Anthony's (36,707), according to state data.

HCA's top two hospitals were St. Petersburg General (29,066) and Largo Medical Center (23,573).

In Hillsborough County, however, HCA's Brandon Regional Hospital had the second-most visits (105,241), trailing only BayCare's St. Joseph's Hospital (118,752), which had the third busiest ER in the state.

Tommy Inzina, BayCare's chief operating officer, didn't object to his rival's new mailers. Perhaps many of those homes that received the mailers are closer to HCA facilities, he said, adding that where patients end up depends largely on EMS protocols. HCA would not specify which neighborhoods got the mailers.

Inzina said BayCare is "top of mind" for many patients, who will therefore think of those hospitals during an emergency. So the group has focused its marketing dollars on other services, such as sports medicine, and left the ER billboards and mailers to HCA.

"We've not had as robust a marketing program around the ERs," he said. "They have been a bit more engaged."

Contact Jodie Tillman at or (813) 226-3374. Follow @JTillmanTimes.