Medical Records Mined by Hospitals Looking for New Customers

Hospitals are digging through medical records in an effort to locate customers who can take advantage of some of their high-cost services. A new report found that medical facilities, which make less money through government-based coverage options, are searching for patients who carry private health insurance.

Patient Records Targeted to Sell High-Cost Services

Hospitals and other medical facilities are looking for new ways to sell prospective patients on their lucrative medical services. Since most patients aren’t just strolling into facilities looking for care, facilities are now digging through patient records then sending out postcards and other communications to gain their attention.

For instance, Provena St. Joseph Medical Center promoted its lung cancer screening for current or former smokers over age 55 last August by mining personal records. The center only contacted individuals living near the hospital who had a stronger likelihood of having smoked based on their age, income, insurance status and other demographic criteria.

Facilities are targeting patients whose financial and medical records show they may benefit from lucrative services such as cancer, heart or orthopedic care. They are using everything from in-house records to data compiled by consumer marketing firms to initiate their direct mail campaigns.

Private Health Insurance Customers Sought for Marketing Campaigns

The majority of hospitals that have started promoting their services to acquire new patients are targeting ones who carry private health insurance since insurers typically pay higher rates than government coverage like Medicaid will allow.

Consumer groups have criticized the medical facilities’ approach to using medical records, as well as only targeting individuals with private coverage to increase their revenue.

Doug Heller, executive director of Consumer Watchdog, a California-based consumer advocacy group, commented that by these facilities cherry-picking the best-paying patients, they are “inherently discriminating against patients who have every right and need for medical information.”

Other consumer groups have said targeting consumers who may bring in higher incomes to pay for recently-purchased equipment or other needs is close to crossing a line into illegality.

Hospitals, on the other hand, insist their targeting tactics are sophisticated and not much different than approaches used in retail, travel and communication industries to acquire customers. Critics, however, speculate that these new tactics come at a time when government and private insurers are tightening reimbursements, causing these facilities to use targeted techniques to make up for lost income.