Are you commercially insured with cancer, heart disease or an orthopedic problem? If so, you are a juicy marketing target for hospitals, which drool over the prospect of high fee for service reimbursements. USA Today (Hospitals mine patient records in search of customers) explores how hospitals are combining their own data with information from consumer marketing agencies to pinpoint likely customers for their services.
The article is a little vague on exactly what aspects of the hospital’s own databases are being tapped. It appears that some elements of financial and medical records (such as insurance status) are being used, but others (such as whether someone is a smoker) are not. Outside consumer marketing agencies can match the hospital’s data up with all sort of other potentially useful information, such as income, household composition and credit worthiness.
Hospitals defend their use of these targeting tools by claiming that bringing more high-reimbursement patients in allows them to devote more resources to free or low-reimbursement care. But it’s difficult to determine whether that’s really occurring, or just a nice thing to say. At least theses marketing efforts do not appear to be focused on reducing access for those with weaker insurance or less profitable conditions.
Hospitals (especially not-for-profit ones) feel compelled to say they’re using these services to help everybody. But as a whole private practice physicians are less concerned about giving altruistic reasons for improving their case mix. Online doctor finder and booking services like ZocDoc and TopDoc ask patients for their insurance information, not just to help patients find in-network doctors, but also to help doctors finds the patients they prefer to work with.
It remains to be seen whether payment reform including Accountable Care Organizations and bundled payments will change the incentives for providers and result in the curtailment of the current cherry picking strategy.