A Medical Credit Score?
Posted by WhiteCoat on January 19, 2008
I’m having a difficult time understanding the purpose of this concept.
MSNBC blog “The Red Tape Chronicles” posted a story about how Fair Issac Corporation is investing $10 million in a Massachusetts startup company named Healthcare Analytics that is developing what amounts to a credit score for healthcare called MedFICO.
The Healthcare Analytics site states that the purpose of this new tool is to “improve a hospital’s financial relationship with patients.”
The average hospital stay is about 5 days; however, the collection period for self-pay balances is typically 6 months or more. HAI’s decision tools will help shorten the process by giving guidance on settlement terms that are equitable, appropriate, and financially manageable for each patient.
I don’t get it. They’re going to use your previous history in paying medical bills to determine how long you get to stay in the hospital? Do people who pay their bills on time get milked for longer hospital stays?
Supposedly, the score would only be used after a patient is discharged from the hospital. A Dallas News article quotes executives from Tenet Healthcare (which also invested $10 million in the Healthcare Analytics startup) as saying that the score “could help them decide whether a given patient can pay his or her bill or if they should just write it off as uncollectible, or a ‘bad debt’ in industry lingo.” Give me a break. This wahoo really wants us to believe that a hospital isn’t going to try to collect from someone just because of a low MedFICO score? Wouldn’t everyone want to have low MedFICO scores, then? Hospitals don’t pay to send someone to collections. If a hospital sends an account to collections, it just pays a percentage of whatever is collected.
The MSNBC post has more than 1600 comments regarding the MedFICO score. Scanning the posts, most people seem put off by the idea. Many seem worried that the score would be used by hospitals to refuse care to patients. I don’t see how implementing such a system will affect a patient’s ability to receive care in a hospital. The hospital can’t discharge you early or refuse you care in the emergency department. The doctors have to make those decisions. Maybe the hospitals would put pressure on the hospitalists to get patients with low MedFICO scores out. Who knows?
Hospitals have the right to make money just like any other corporation, but I don’t think it is ethical or appropriate to charge different people different prices for the same product just because one person has a high MedFICO score and another person has a low MedFICO score. I wonder if this is one of their goals.
I have a few guesses about how this score will really be used:
- First, if physicians have access to the scoring system, the score may affect the willingness of doctors to accept someone as a patient. Does that mean the patient won’t get care? Probably not. As George Bush said last summer, “you can always go to the emergency room.” (sixteenth paragraph). But if doctors are unwilling to accept someone as a patient for routine medical problems, preventative care goes out the window and the patient is forced to wait until an “emergency” develops to get treated for the problem. Once the “emergency” is averted, the patient waits for another emergency.
- If the score will be accessible to employers who provide health insurance, it could be used as a tool to cherry pick healthy employees in order to keep insurance costs down. If you have chronic diseases and utilize medical services excessively, who says you can’t be fired for some other reason as a pretense. If the company can access your MedFICO score before they hire you, who says the company has to hire you at all?
- I’m not sure why hospitals would want the score. I don’t know if it would be used to put pressure on someone who hasn’t paid their bill (”You’ll ruin your MedFICO score if you don’t pay”) or if it would be used to market their services to patients who are likely to be profitable. Good MedFICO score (with lots of medical visits) + good credit score = big bucks for hospital.
Commenters to the MSNBC post noted the potential for identity theft and the possibility that the score could be confused with someone else’s score. These are some of the other down sides to creating such a tool. You can bet that if large corporations are investing tens of millions of dollars to create the score, sooner or later it’s going to be implemented.
Whatever the real reason for its use, the MedFICO score is just one more piece of our privacy that is going to be stripped away.
Other articles about this idea posted at the Chicago Tribune, Minneapolis Star-Tribune, and San Jose Mercury News.
makeminetrauma said
Having started out in the business office at my first hospital, I can tell you that there are people who specialize in self pay patient accounts and do exactly what this company is proposing minus the bogus credit score. The account rep works closely with these patients to come up with an agreeable payment plan so that everyone may avoid collections.
Healthcare Analytics is just out to prey on the hospital administrators by promising saved $$$$ and make a giant profit in the aftermath.
Since I have no clue about this aspect of medicine, can you give me an idea of what the selling point for MedFICO scores to the hospitals would be? Would account reps not pursue someone as aggressively with a low MedFICO score? Couldn’t the account rep get a better idea of ability to pay just using a credit report?
Pam said
I don’t know about the medical credit score being used generally but do know from first hand experience about negociating on paying a high bill for surgery over many months.
SeaSpray said
One thing though…if employers could access this medFICO score…then doesn’t that violate HIPPA regulations or how else would they know if you are a poor health risk to the corporation? I never got seriously sick until the stupid big kidney stone that wreaked havoc on my ureter. In my 20 years working at the hospital I never abused my sick time but always had to rush to take time off or I would lose what was in my time bank. Then I had this chronic stuff with the ureter (now healed thank you wonderful urodoc)and all these bills quickly accrued. It both alarms and aggravates me to think that someone wouldn’t see my value as an employee but as a potential financial risk instead.
BTW…”cherry pick healthy employees”…wouldn’t that be DISCRIMINATION? How could such a violation of privacy be allowed?
Supposing this could happen…then people that WANT to work, earn a salary and yes have benefits like everyone else would be prevented from getting the desired job and possibly not get one as good and so go further in debt and then at some point become a burden on the system anyway?
I hate how employees have become so dispensable and how everything seems to be about the almighty dollar. Yes money is important and we all need it and it makes things nice…but people have value too. Anyone at anytime in their life can come upon hard times but it doesn’t mean you will stay there…unless your brother keeps pulling the rug out from under you and kicking you when you are down.
Dr. Kranky said
I know nothing about this issue, but here’s my take on how these companies will make money: since a pool of patients who can’t or won’t pay their bill exists, and since hospitals already dedicate a certain amount of time and energy (including apparently some individuals dedicated to such payment problems), these companies seem to be proposing an “outsourcing” of this task to them by claiming that they will do it more efficiently. That is, since they have reams of data they can mine, which ends up being expressed as this MedFICO score, they can quickly and efficiently pick out the “deadbeats” and focus on them with laser-like attention, thereby “saving” the hospitals many “false starts” and “dead ends.”
Whether there are more sinister intentions and extrapolations in the works is anyone’s guess.
cowgalutah said
just what we need is a longer line in the ER…for things that could have been seen at the Dr’s office for normal care.
MedFICO score and You | change:healthcare said
[...] now along comes your MedFICO score from Healthcare Analytics like a consumer’s credit rating! What’s a [...]
Scratching My Head?? said
I am quite surprised and even shocked. You can call this whatever you want, doctors, health care workers, hospital admin., and the giant managed health care companies. This is a perfect example of WHY WE NEED UNIVERSAL HEALTH IN THE USA! Stand up folks, time for change is long overdue! We cannot stand by complacently and allow this to occur. We’ve already signed our legal rights away with the ominous “Arbitration” Clauses written quite passively in our statements, insurance binders and the like. This is nothing more than a TOOL to create more biased decisioning on the part of managed health care. ENOUGH!
Noah_Bodie said
SeaSpray, on the face of it, based on what I know and what I’ve read, there appear to be no HIPPA violations. One exception would be if say this new credit bureau (Healthcare Analytics) were to identify a tradeline on one’s credit report in such a way that someone could figure out the type of treatment. For example, reporting that one owed money to Fred Hutchinson Cancer Research Center, that would violate HIPPA.
medFICO will make Healthcare Analytics a new “consumer reporting agency” (CRA) and make any doctor or hospital a “furnisher of data”–as defined and used in the Fair Credit Reporting Act (FCRA).
As credit industry newcomers, they likely won’t get it right. Forget long lines at the hospital, there’s going to be long lines at Federal District courthouses. There’s no individual right to sue under HIPPA, but the individual can sue under FCRA. “Willful noncompliance” with the FCRA means punitive damages.
Cha-ching.
Markdeviz said
Hello
nice posting Keep it up
robert berner said
I am a writer for Business Week Magazine. I am doing research on how medical credit scoring, or other high-tech assessments of patients ability to pay at the point of intake, is affecting care. I am looking to talk to medical professionals, such as ER doctors, admissions staff, who I can talk to about this topic. Feel free to e-mail me at robert_berner@businessweek.com or call collect at 312-233-7944. Thanks, Robert Berner
markdeviz said
Nice posting – keep it up
maxy said
Nice
rajender said
I have no idea why iam charged for FICO and MEDFICO on my salary can u let me know about this in detail .
carluew said
I found something called a cpn number that will
give you a new credit profile within 30 days.
the website is
http://www.creditmenow.info
A Loophole for Medical Bankruptcy « WhiteCoat’s Call Room said
[...] and high debt loads? You connect the dots. I’m beginning to see where this whole “medical credit score” is coming into play. It really is going to be used to decide whether or not to provide [...]
cardcreditfreescore said
I am amazed with it. It is a good thing for my research. Thanks. ^_^
"MedFICO" Scoring System Is Being Developed - Philadelphia Speaks said
[...] Scoring System Is Being Developed Here: A Medical Credit Score? WhiteCoat Rants And here: Worried about your medFICO score? | ZDNet Healthcare | ZDNet.com A new MedFICO credit [...]
Ward said
Just another reason why single payer, universal health care is so important. The for profit industry is spending millions on this stuff only. because it knows it can charge health care providers for the information. More administrative cost. Less health care.
mimi said
We’re all going to Hell.