Good Samaritan offered big discounts to managed-care plans in return for promises of large patient volume. The gamble paid off at first. Big medical groups and HMOs responded by steering hundreds of patients a year to the deepest discounter in town. Defending its record, Good Samaritan pointed out that the later mortality data weren't adjusted for the hospital's unique mix of easy and hard cases, including repeat surgeries on patients whose initial bypass grafts had stopped working well. Mr. Anders gives a concise overview of the hospitals' reactions.
Offering discounted surgery is just one of the ways hospitals have changed their practices.
Some efficiency campaigns have actually improved patient care by eliminating needless delays or outdated practices. Janet Monroe has learned about HMOs' indifference the hard way. She likes to present such data at negotiating sessions with HMOs, hoping they will pay extra for her hospital. Unless there's just a huge, gaping difference between hospitals, though, the decision is based on price, price, price. The article goes on to site other instances where pricing needs make a difference in medical care.