Becker's Hospital Review

12 CFO / FINANCE HCA execs keep cost-cutting plan in back pocket By Ayla Ellison N ashville, Tenn.-based HCA Health- care's profit climbed to $668 million in the third quarter of 2020, but the for-profit hospital operator is planning for a small drop in admissions in 2021, according to the Nashville Post. e 187-hospital system is building forecasts for 2021 based on 2019 volumes. e compa- ny expects demand for inpatient admissions in 2021 will be down 2 percent to 3 percent from 2019, executives said during an earn- ings call Oct. 26. HCA expects a drop in emergency room visits as well. "But like our inpatient business, we expect it to be more acute, which should drive high- er revenue per visits, offsetting some of the volume decline," HCA CEO Sam Hazen said during the earnings call. Mr. Hazen said managing operating costs has been a key part to the company's solid fi- nancial results in 2020, and the company is identifying areas it can further reduce costs, according to the Nashville Post. "In those areas where we anticipate some pressure, we believe we have future resiliency actions that help offset some of these chal- lenges," Mr. Hazen said. When asked for more information, Mr. Ha- zen said HCA's call centers and lab services group could be streamlined. "We're challenging how we're structured to see again if we have redundancies in our structure and whether or not there are bet- ter ways to service the field and produce out- comes on that front," Mr. Hazen said. ere are also opportunities to use technol- ogy initiatives to save on expenses and im- prove patient outcomes. "We think these work streams … have op- portunities for the company … to offset any pressures that might serve us in 2021 and on into 2022," Mr. Hazen said. n M Health Fairview closes 137-year-old Minnesota hospital By Alia Paavola M inneapolis-based M Health Fairview offi- cially closed the 137-year-old Bethesda Hospital in St. Paul, Minn., Nov. 13. The long-term care hospital was converted into a COVID-19 facility for M Heath Fairview in March 2020. But the health system moved the last patient Nov. 5 from its 90-bed COVID unit to St. Joseph's Hospital in St. Paul and shuttered the facility Nov. 13, according to M Health Fairview spokesperson Aimee Jordan. M Health Fairview announced plans to downsize its hospital operations and reduce its workforce in October. The system said the changes were necessary because it is bracing for a $250 million operating loss in 2020, exacerbated by the pan- demic. In addition to closing Bethesda Hospital, the sys- tem plans to close 16 of its 56 clinics in Minnesota and Wisconsin and stop offering some services at St. Joseph's Hospital, including emergency de- partment services. Ms. Jordan added that its COVID-19 unit, includ- ing staff, has been transferred to St. Joseph's Hospital, where it will remain until it is no longer needed in the community. St. Joseph's Hospital has more capacity to care for COVID-19 patients than Bethesda Hospital, Ms. Jordan said. n ER physicians accuse UnitedHealth of illegally underpaying claims By Ayla Ellison S everal emergency room physician practices in New York filed a federal lawsuit in November alleging UnitedHealth Group and MultiPlan conspired to underpay out-of-network ER providers. In their federal complaint, filed Nov. 2, five ER physician groups allege UnitedHealth failed to pay them the "reasonable" rate for out-of-network claims. The physicians are legally entitled to the "reasonable" rate for their services, which is the "usual and custom- ary rates" for similar providers in the same area. The lawsuit claims UnitedHealth used data from MultiPlan's Data iSight software to support underpaying out-of-network claims. The physicians' lawsuit asserts claims under the federal Racketeer Influenced and Corrupt Organizations Act and New York state law. The physicians are seeking monetary, injunctive and declar- atory relief. In a statement to Becker's Hospital Review, UnitedHealth says it be- lieves the lawsuit is "meritless." "A small number of providers, and especially private equi- ty-backed physician staffing companies like TeamHealth, are driv- ing up the cost of care for the people and customers we serve. Some of the TeamHealth provider groups that are not part of our network today charge 700-900% of Medicare rates for the care they provide," UnitedHealth said. "This sort of excessive pricing from out-of-network providers contributes to skyrocketing health- care costs for everyone. TeamHealth has filed a lawsuit in an at- tempt to challenge our efforts to address the unreasonable and anticompetitive rates its providers charge. We believe the lawsuit is meritless and plan to aggressively defend ourselves against TeamHealth's baseless claims." n

• Cover