(Before It's News)
During the Great Recession, when
many hospitals across the country were nearly brought to their knees by growing
numbers of uninsured patients, one hospital system not only survived — it
thrived.
In fact, profits at the health care
industry giant
HCA, which controls 163
hospitals from New Hampshire to California,
have soared, far outpacing those of most
of its competitors.
The big winners have been three
private equity firms
— including Bain Capital, co-founded by Mitt Romney, the Republican
presidential candidate — that bought HCA in late 2006.
HCA’s robust profit growth has raised
the value of the firms’ holdings to nearly three and a half times their initial
investment in the $33 billion deal. The financial performance has been so
impressive that HCA has become a model for the industry. Its success inspired
35 buyouts of hospitals or chains of facilities in the last two and a half
years by private equity firms eager to repeat that windfall.
HCA’s emergence as a powerful leader in
the hospital industry is all the more remarkable because only a decade ago the
company was badly shaken by a wide-ranging
Medicarefraud investigation that it eventually settled
for more than $1.7 billion.
Among the secrets to HCA’s success: It
figured out how to get more revenue from private insurance companies, patients
and Medicare by billing much more aggressively for its services than ever
before; it found ways to reduce emergency room overcrowding and expenses; and
it experimented with ways to reduce the cost of medical staff, a move that
sometimes led to conflicts with doctors and nurses over concerns about patient
care.
In late 2008, for instance, HCA changed
the billing codes it assigned to sick and injured patients who came into the emergency
rooms. Almost overnight, the numbers of patients who HCA said needed more care,
which would be paid for at significantly higher levels by Medicare, surged.
HCA, which had lagged the industry for
those high-paying categories, jumped ahead of its competitors and was
reimbursed accordingly. The change, which HCA’s executives said better
reflected the service being provided,
increased operating earningsby nearly $100 million in the first quarter of
2009.
To some, HCA successfully pushed the
envelope in its interpretation of existing Medicare rules. “If HCA can do it,
why can’t we?” asked a hospital consulting firm, the Advisory Board Company, in
a presentation to its clients.
In one instance, HCA executives said a
private insurer, which it declined to name, questioned the new billing system,
forcing it to return some of the money it had collected.
Let me speculate here: Might Romney’s tax returns for the
few years preceding 2010 show an interest in the Bain fund that continues to own a large
share in HCA even though HCA went public last year?*
Just asking.
—-
*The New York Times article explains:
In the spring of
2011, in one of the most closely watched public offerings since the financial
crisis, HCA became a public company once again. Its three buyout owners each
sold another $500 million worth of stock, allowing them to recoup all their
initial investment.
Last fall, HCA agreed to buy back the stake held by Bank of
America, which had purchased Merrill Lynch in 2009, for $1.5 billion, giving
the bank a return of two and a half times its initial investment. And earlier
this year, HCA paid out $900 million in dividends, of which $360 million went
to K.K.R. and Bain.
The 40
percent stake in HCA still held by K.K.R. and Bain is worth about $4.8 billion
at current levels, giving them a potential profit, with the dividends they have
received, of three and a half times their initial investment of $1.2 billion
each.
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