Fairview hospital employees used high-pressure tactics in emergency rooms, cancer units and delivery wards to try to collect money from patients before they were treated, according to a blistering report issued Tuesday by Minnesota Attorney General Lori Swanson.

The collections strategy, designed by an Illinois consulting firm called Accretive Health, was so heavy-handed that several doctors complained it might discourage patients from seeking medical care, the report found.

Swanson said the practices, uncovered during a review of Fairview’s management contracts with Accretive, appear to have violated federal and state laws, including those regulating debt collection and patient privacy.

“Perhaps the most damaging act … was to undermine the basic premise that a hospital is a sanctuary to treat the sick and infirm,” the report said.

Fairview issued a brief statement Tuesday saying it has cooperated with Swanson and shares her concerns about the practices. Fairview announced that it has dropped Accretive as its revenue manager, although it continues to use the consulting firm for other services.

The statement did not say what, if anything, Fairview officials knew about the collection practices. “We continue to evaluate issues raised by the Attorney General and will take action as appropriate,” it said.

Swanson’s probe found that Accretive employed collection quotas, cash inducements and in-house competitions using National Football League team names to motivate staff members to squeeze upfront payments from patients. At patient registration desks, for example, employees were told to follow lengthy scripts, written by Accretive, to press patients for payments before they got treatment, according to the six-volume report.

In one case, a child who sought treatment at the University of Minnesota Amplatz Emergency Room reportedly was kept waiting while the parents, who were uninsured, met with an Accretive “financial counselor.” The incident prompted the hospital’s own employees to question whether Accretive was violating federal law, which requires emergency rooms to see patients without such delays.

Accretive, whose founder and CEO is Mary Tolan, a former director of Best Buy Inc., declined to field questions Tuesday, but issued a statement saying, “We have a great track record of helping hospitals enhance their quality of care. For example, we have helped over 250,000 patients get insurance coverage.”

Lost laptop

One of the nation’s largest medical debt-collection firms, Accretive came to Swanson’s attention last summer, when an employee lost a laptop computer containing personal data on thousands of Fairview patients. Swanson later sued the company, alleging it failed to protect the confidentiality of patient records or tell patients about its role in managing the revenue and care delivery at two local hospital systems.

By Tony Kennedy and Maura Lerner
Distributed by MCT Information Services