Billed three times for three ER visits, woman sees doctor just once

Imagine going to a hospital emergency room and not seeing a doctor.

It happened to Natasha Valle, and Modern Healthcare reports it’s the latest consequence of private equity investors taking over hospital ownership and management.

Valle, who lives in Tennessee, was pregnant and experiencing bleeding and cramping. She feared she was having a miscarriage. It took three trips to the ER on three consecutive days before she finally saw a doctor. That doctor looked at her bloodwork and confirmed her fears: She was miscarrying.

It’s unclear whether seeing a doctor during her two previous visits would have ultimately changed the outcome or the fact that Valle was billed for three visits. But her experience does shine a light on a little-known practice. About a year and a half before Valle’s visit, the hospital had outsourced its emergency rooms to American Physician Partners, a medical staffing company owned by private equity investors.

Private equity companies invest money from wealthy investors into various industries, with health care being a new and lucrative area of interest. A study published in the Journal of American Medicine (JAMA) found physician groups charged insurers 20% more on average after they were bought by a private equity firm.

Documents obtained by Kaiser Health News and National Public Radio indicate American Physician Partners employs fewer doctors in its emergency rooms as one of its cost-saving, profit-boosting strategies. Instead, American Physician Partners employs nurse practitioners and physician assistants, who have less training than medical doctors and who also earn lower salaries.

Critics say this practice leaves patients vulnerable to misdiagnoses, higher medical bills and lower-quality care. Many experts said they have no issue deploying nurse practitioners and physician assistants in certain circumstances, including when no doctor is available.

Do you think it’s important to see a physician during an ER visit? Is this a good way for hospitals to cut costs and/or increase profits? Share your thoughts with Voices for Affordable Health.