By Jill Arnold
A segment last night on CBS's 60 Minutes called "Hospitals: The cost of admission" aired allegations by multiple former employees of Naples-based Health Management Associates (HMA) that the corporation heavily pressures doctors to admit patients regardless of medical need to meet an arbitrary target percentage.
HMA had a prepared response ready before the story aired.
Three days prior to the story airing, HMA was referenced in a New York Times article titled "A Hospital War Reflects a Bind for Doctors in the U.S."
A supplemental report on historical hospital-level cesarean rates was published on November 18, 2012 along with a state report on Mississippi cesarean rates which coincidentally noted all HMA-owned hospitals in Mississippi.
In response to the CBS segment on HMA, here is a rough report of cesarean rates at HMA hospitals with maternity services. Only one conclusion can be drawn from this report (see disclaimer about quality of data and its application), which is that hospital data transparency will help foster a culture of accountability by sending up a red flag to see if further investigation is needed. Doctors should not experience, as the aforementioned New York Times article states, "growing pressure to meet the financial goals of their new employers — often by performing unnecessary tests and procedures or by admitting patients who do not need a hospital stay."
These are the best data publicly available on cesarean rates. Some states do not publish any data, nor are the numbers needed to calculate rates available elsewhere. The year of acquisition or partnering with HMA was not clear from some of the hospitals' web sites. If there is any connection between HMA's alleged profit-driven admission targets and utilization rates of the cesarean section and other associated billable procedures, hopefully these numbers can serve as a launch pad for anyone wishing to investigate further.