Utah’s largest hospital chain sticking with embattled debt collector

Utah » Intermountain says its work with Accretive Health won’t mirror Minnesota chain’s.

< Previous Page

Intermountain does this now, seeking payment when patients register for surgery or enter the hospital emergency department, though only after they’ve been assessed, said Johnson.

Still, exposure of Accretive’s practices drew unflattering media attention, causing the company’s stock to tumble and a California congressman to call for a federal investigation.

Fairview severed ties with Accretive last month, a decision "made in the best interests of our patients and our organization," said a spokesman Ryan Davenport.

Prior to that, Accretive had full authority over its billing. The company was empowered to fire and reassign Fairview employees, who were required to use a computer system nicknamed "Blue Balls," which tracks whether patients pay their bills, according to Swanson’s report.

Emergency room "financial counselors" were taught to ask for payment at the bedside in ways that led patients to think they would be denied treatment without it, the report claimed.

If the patient didn’t have a credit card handy, employees asked for a checkbook or encouraged the patient to borrow from a family member. They were told to remind patients that if the bill goes to collections, it can affect their credit.

"Fairview emergency workers got the message that if they didn’t collect money in the ER, they would be fired," the report said.

Registration staff ran reports on incoming patients, flagging those with past due balances, including breast cancer patients and moms in labor and delivery. This prompted some Fairview doctors to complain to the Minnesota AG that patients were being chased away and forgoing treatment.

Swanson accuses Accretive of breaching patient privacy laws after an employee last year lost an un-encrypted laptop containing 23,500 patient records.

The arrangement was profitable. Accretive generated about $826 million in revenue in 2011, 12 percent, or $100 million, of which came from Fairview, Swanson says.

It earned those profits, in part, by downsizing staff and outsourcing work to "centers of excellence" in India and Pakistan, she alleges.

"As a for-profit, private corporation, Accretive may boost its stock value by off-shoring jobs to India. It is troubling, however, for Accretive to do so with the assets of a Minnesota charitable organization."

In a pass through arrangement, Accretive managed payroll for Fairview’s billing employees. It shared in the money that was earned by boosting collections or cutting costs.

Johnson said there are currently no plans to outsource any of Intermountain’s 1,600 revenue management workers, but says the relationship with Accretive is evolving.

Intermountain is in the driver’s seat and must approve any change in policy or practice, he said. The health system’s charity care policy will remain intact. Once the hospital decides a bill has become bad debt, it will be passed to other vendors and Accretive will not have a role in that collecting, he said.

Johnson, though, said confidentiality agreements forbid him from explaining how money will flow between Intermountain and Accretive. The Center of Excellence they build will be owned and operated by Accretive, he stressed.

Still, some employees are nervous and worry that Intermountain is drifting from its non-profit roots, said an employee who fears being fired and The Tribune agreed not to identify.

kstewart@sltrib.com

Twitter: @kirstendstewart

Copyright 2013 The Salt Lake Tribune. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

About Reader Comments

---

Reader comments on sltrib.com are the opinions of the writer, not The Salt Lake Tribune. We will delete comments containing obscenities, personal attacks and inappropriate or offensive remarks. Flagrant or repeat violators will be banned. If you see an objectionable comment, please alert us by clicking the arrow on the upper right side of the comment and selecting "Flag comment as inappropriate". If you've recently registered with Disqus or aren't seeing your comments immediately, you may need to verify your email address. To do so, visit disqus.com/account.
See more about comments here.