Federal funds to bailout hospitals misused.

[southernhybrid]

The problems with America's healthcare system are numerous. Among them is the fraud and abuse that happens in Medicare and Medicaid, the absurd high prices that we or our insurance companies pay for services, etc. etc. But, when I read about the misuse of federal funds that were supposed to be used to help maintain the pay of workers, that was something that even I never expected.

I read the following linked article and even I was shocked at how these hospitals misused the funds.

https://www.nytimes.com/2020/06/08/business/hospitals-bailouts-ceo-pay.html

HCA Healthcare is one of the world’s wealthiest hospital chains. It earned more than $7 billion in profits over the past two years. It is worth $36 billion. It paid its chief executive $26 million in 2019.

But as the coronavirus swept the country, employees at HCA repeatedly complained that the company was not providing adequate protective gear to nurses, medical technicians and cleaning staff. Last month, HCA executives warned that they would lay off thousands of nurses if they didn’t agree to wage freezes and other concessions.

A few weeks earlier, HCA had received about $1 billion in bailout funds from the federal government, part of an effort to stabilize hospitals during the pandemic.

HCA is among a long list of deep-pocketed health care companies that have received billions of dollars in taxpayer funds but are laying off or cutting the pay of tens of thousands of doctors, nurses and lower-paid workers. Many have continued to pay their top executives millions, although some executives have taken modest pay cuts.

HCA’s $1 billion in federal grants appears to make it the largest beneficiary of health care bailout funds. But its medical workers have a long list of complaints about what they see as penny-pinching practices.

Since the pandemic began, medical workers at 19 HCA hospitals have filed complaints with the Occupational Safety and Health Administration about the lack of respirator masks and being forced to reuse medical gowns, according to copies of the complaints reviewed by The Times.

Ed Fishbough, an HCA spokesman, said that despite a global shortage of masks and other protective gear, the company had “provided appropriate P.P.E., including a universal masking policy implemented in March requiring all staff in all areas to wear masks, including N95s, in line with C.D.C. guidance.”

The article contains a lot more information and this didn't happen only at profit making hospitals. It also happened at so called non profits like the Mayo Clinic, for example. These large non profits are a bit of a scam imo. I'm not saying that their care is inferior and to be honest, I don't know exactly how to explain how they obtain non profit status and how they misuse that concept.

When I worked as a QA nurse in home health, I saw widespread abuse of Medicare. This never happened when I worked for a government owned agency. I could give many more examples, but I'm trying to keep the post from becoming too long.

Medicare copays and premiums have been rising quite a bit. My guess is that part of the reason is due to over billing for services. My copay was only 5 dollars for the visit, because I have switched to an Advantage Plan. If you don't know what that is, it's a Medicare program provided by private insurance companies but heavily subsidized by the government. These usually offer additional services like dental, vision and hearing. None of that is covered by traditional Medicare.

Anyone have a solution? I sure don't. Please don't say Medicare for all is the answer unless you can explain exactly how that would work, how it could be done with affordable premiums and copays, what could be done to eliminate fraud and abuse and how hospitals that depend on the much higher rates they currently receive from private insurance companies can manage on the much lower Medicare reimbursement rates. It's complicated.

 

[Toni]

The problems with America's healthcare system are numerous. Among them is the fraud and abuse that happens in Medicare and Medicaid, the absurd high prices that we or our insurance companies pay for services, etc. etc. But, when I read about the misuse of federal funds that were supposed to be used to help maintain the pay of workers, that was something that even I never expected.

I read the following linked article and even I was shocked at how these hospitals misused the funds.

https://www.nytimes.com/2020/06/08/business/hospitals-bailouts-ceo-pay.html

HCA Healthcare is one of the world’s wealthiest hospital chains. It earned more than $7 billion in profits over the past two years. It is worth $36 billion. It paid its chief executive $26 million in 2019.

But as the coronavirus swept the country, employees at HCA repeatedly complained that the company was not providing adequate protective gear to nurses, medical technicians and cleaning staff. Last month, HCA executives warned that they would lay off thousands of nurses if they didn’t agree to wage freezes and other concessions.

A few weeks earlier, HCA had received about $1 billion in bailout funds from the federal government, part of an effort to stabilize hospitals during the pandemic.

HCA is among a long list of deep-pocketed health care companies that have received billions of dollars in taxpayer funds but are laying off or cutting the pay of tens of thousands of doctors, nurses and lower-paid workers. Many have continued to pay their top executives millions, although some executives have taken modest pay cuts.

HCA’s $1 billion in federal grants appears to make it the largest beneficiary of health care bailout funds. But its medical workers have a long list of complaints about what they see as penny-pinching practices.

Since the pandemic began, medical workers at 19 HCA hospitals have filed complaints with the Occupational Safety and Health Administration about the lack of respirator masks and being forced to reuse medical gowns, according to copies of the complaints reviewed by The Times.

Ed Fishbough, an HCA spokesman, said that despite a global shortage of masks and other protective gear, the company had “provided appropriate P.P.E., including a universal masking policy implemented in March requiring all staff in all areas to wear masks, including N95s, in line with C.D.C. guidance.”

The article contains a lot more information and this didn't happen only at profit making hospitals. It also happened at so called non profits like the Mayo Clinic, for example. These large non profits are a bit of a scam imo. I'm not saying that their care is inferior and to be honest, I don't know exactly how to explain how they obtain non profit status and how they misuse that concept.

When I worked as a QA nurse in home health, I saw widespread abuse of Medicare. This never happened when I worked for a government owned agency. I could give many more examples, but I'm trying to keep the post from becoming too long.

Medicare copays and premiums have been rising quite a bit. My guess is that part of the reason is due to over billing for services. My copay was only 5 dollars for the visit, because I have switched to an Advantage Plan. If you don't know what that is, it's a Medicare program provided by private insurance companies but heavily subsidized by the government. These usually offer additional services like dental, vision and hearing. None of that is covered by traditional Medicare.

Anyone have a solution? I sure don't. Please don't say Medicare for all is the answer unless you can explain exactly how that would work, how it could be done with affordable premiums and copays, what could be done to eliminate fraud and abuse and how hospitals that depend on the much higher rates they currently receive from private insurance companies can manage on the much lower Medicare reimbursement rates. It's complicated.

Are you actually familiar with Mayo Clinic?

 

[southernhybrid]

Yes. Of course I am. I'm just relaying what was in the article. Emory, Mayo Clinic are both non profits, but non profit doesn't mean that they don't misuse funds or pay their CEOs extravagant salaries. I'm not criticizing the quality of care at these places. I'm criticizing their misuse of funds, as was reported in the article.

From the article:

The New York Times analyzed tax and securities filings by 60 of the country’s largest hospital chains, which have received a total of more than $15 billion in emergency funds through the economic stimulus package in the federal CARES Act.

The hospitals — including publicly traded juggernauts like HCA and Tenet Healthcare, elite nonprofits like the Mayo Clinic, and regional chains with thousands of beds and billions in cash — are collectively sitting on tens of billions of dollars of cash reserves that are supposed to help them weather an unanticipated storm. And together, they awarded the five highest-paid officials at each chain about $874 million in the most recent year for which they have disclosed their finances.

Emory is also an elite nonprofit that has an enormous amount of money. I think the point is that some of these nonprofits misuse money just like the big profit making hospital chains do. Sorry if my point wasn't clear.

 

[Toni]

Yes. Of course I am. I'm just relaying what was in the article. Emory, Mayo Clinic are both non profits, but non profit doesn't mean that they don't misuse funds or pay their CEOs extravagant salaries. I'm not criticizing the quality of care at these places. I'm criticizing their misuse of funds, as was reported in the article.

From the article:

The New York Times analyzed tax and securities filings by 60 of the country’s largest hospital chains, which have received a total of more than $15 billion in emergency funds through the economic stimulus package in the federal CARES Act.

The hospitals — including publicly traded juggernauts like HCA and Tenet Healthcare, elite nonprofits like the Mayo Clinic, and regional chains with thousands of beds and billions in cash — are collectively sitting on tens of billions of dollars of cash reserves that are supposed to help them weather an unanticipated storm. And together, they awarded the five highest-paid officials at each chain about $874 million in the most recent year for which they have disclosed their finances.

Emory is also an elite nonprofit that has an enormous amount of money. I think the point is that some of these nonprofits misuse money just like the big profit making hospital chains do. Sorry if my point wasn't clear.

Mayo's current CEO is being paid something like $1.9 Million--which is a crap ton of money but fairly modest by comparison to some other corporations and health care systems.Johns Hopkins pays their CEO something like $15 Million.

I have a number of friends who work at the main Mayo campus in Minnesota. What has happened there (and at its affiliates) is what has happened many places: Procedures and treatments and appointments that could be postponed during the pandemic were postponed. A LOT of people were furloughed even as others in areas related to the pandemic were working overtime. Labs that had operated on a 16 hr/6 day a week work week were--and are working 24/7. As you know, skill sets are not immediately transferable from one area to another. One highly skilled team in say, orthopedics is not necessarily competent to deal with infectious disease or severe respiratory illnesses. I know that Mayo Clinic's revenue is down substantially because so much that is not COVID related has been slowed/postponed. But these facilities/staff/resources are still necessary even if they are temporarily on pause. Staff who are furloughed are still covered by health insurance and retirement benefits so those are fixed costs regardless of income. Mayo is doing its best to spread the pain so that fewer employees are feeling a negative impact and that the impact is less severe. One of my friends works in a lab doing COVID RNA testing and now, antibody testing. Her husband works in a different part of Mayo. My friend has been working overtime for months. Her husband is furloughed for 3 months, working one week on/one week off. Mayo physicians are paid by salary, not per patient or procedure.

While I am not in love with some of the changes that have happened at Mayo as it's acquired numerous community based health care systems, I think it's not necessarily correct to say that it is 'mis-using' funds. Just to look at one way that Mayo and other health care systems have had to make expensive adaptations: They are all working on developing new testing for this new virus. They are also doing new testing to detect COVID RNA, antigen and now antibody testing. There is a fairly large cost to implementing these new tests even if the tests are run on the same platforms already in use in a lab.