Disgraceful Behavior at Fairview - University of Minnesota 

Children's Hospital 

I have been disgusted for some time with the University of Minnesota's association with Fairview in the children's hospital wars in Minneapolis and St. Paul.  This has resulted in a huge and unnecessary investment in new buildings that is a very good example of how flawed our health care system truly is.

Background

 "Children as Pawns in the Latest Expensive Healthcare Competition."

"Are Layoffs at Fairview/University of Minnesota Completely Unrelated to Children's Hospital Wars?"

From MinnPost:

Attorney General: Fairview Embedded Debt Collectors in Hospital

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." 

 [this is actually a quote from the Strib - link]

According to the attorney general’s report, Accretive was derisive of such questions and complaints, even when they came from doctors. "I'm assuming this is a country club conversation that is getting floated around,'' an Accretive manager wrote in an e-mail to another employee.

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To make things even worse, it appears that two of the sons of Fairview executives were employed by the embedded debt collection agency. 


As described by the Star-Tribune:

Fairview execs had links with debt firm under fire

Two Fairview executives who helped forge a partnership with a debt collection company under fire for its aggressive tactics have sons who work for the firm, the Star Tribune has learned.

 One of the Fairview officials, Dr. Dave Moen, also owned stock in the collection firm, Accretive Health Inc. His son, 24-year-old Sam Moen, works for Accretive and helped implement the high-pressure strategies that Minnesota Attorney General Lori Swanson blasted this week, documents show. Fairview's CEO, Mark Eustis, also has a son who works for Accretive.

Fairview officials now admit that "mistakes were made" by Accretive employees who allegedly hounded patients at its hospitals.

The Eustis and Moen family relationships and Moen's ownership of Accretive stock were disclosed to the board of directors and vetted before Fairview signed contracts with Accretive in 2010, Mooty said.

He called Eustis a person of "incredibly high integrity'' who is deeply loyal to Fairview. The CEO wouldn't let his son's job influence his management of the Fairview-Accretive relationship, Mooty said.

However, to Prof. David Shultz, a lawyer and ethicist at Hamline University, the conflicts were severe and not defensible simply because they were disclosed.

"This is a pretty bad one,'' said Shultz, an expert in business ethics and the governance of nonprofits.

He said Moen and Eustis could have been swayed in their support of Accretive out of loyalty to their sons, if only subconsciously. Moen's stock in Accretive, which Fairview didn't disclose in detail, provided another level of bias, Shultz said.

To what should be no one's surprise, comments on this situation on the Star-Tribune website were scathing:

Ironic that U of M Fairview Hospital engages an Accretive manager named Crooks to respond to physician complaints about alleged patient harassment and abusive financial intimidation tactics that may violate state and federal law. Fairview Hospitals should issue a public statement apologizing for confirmed misconduct alleged by the Minnesota Attorney General's office, and promise to refrain from any and all misconduct in the future. People who are, or thinking about becoming, contributing donors to the U of M Fairview Amplatz Children's Hospital may feel compelled to put their contribution pledges on hold unless and until they are publicly assured by Fairview's attorneys, CEO and board of directors that patients and their families will be consistently treated with dignity and respect at all Fairview medical facilities, and will never be subjected to the despicable financial intimidation tactics alleged by Attorney General Lori Swanson.


The Star Tribune should check spelling on its copy more carefully. It's not Accretive Health, it's Accretive Wealth.

"Mistakes"? The only "mistake" is that they got caught.

This is not new for Fairview. In 2000, a family member, who had lost a job and was not sure if they were still covered, was utterly harrassed by staff regarding payment while a patient.

Another day at the medicine for profit machine.

There seems to be a complete disconnect from Fairview's mission and the Farivew administrators who signed off on Accretive Health's hapless collection scheme.

Ya think? You head to the hospital with some broken bones and who meets you at the door but Tony the Enforcer and a couple of his leg breakers, acting like they work for some loan shark.

How we've perverted that word, "mistake." Breaking the law when you know are, but think you won't get caught, is not a mistake.

Goon squads like Accretive Stealth are just filling a demand.

Ya gotta love the passivity in the phrasing "Mistakes were made." I wonder if Fairview executives are similarly unaccountable when they're upholding their performance to their board at bonus time in asserting, for example, "Profits were made." As in "We may or may not have had anything to do with having accumulated them." I'm going to guess their modesty is a bit less in evidence in those circumstances.

"Mistakes were made", what a load of unmitigated gall and arrogance. Having looked at Accretive Health's website, I find it almost impossible to believe that any intelligent, educated person would believe the claims made.

Fairview is a not-for-profit health system. They are designated and are promised favorable tax treatment in exchange for a willingness to treat all patients who come through the door. This episode shows that they out and out disregard that promise. By doing so, the state and federal government should strip them of their not-for-profit status and make them pay taxes on their tremendous revenue.

It's totally an 'oops we got caught' situation where they thought they could get away with thugs and scheisters strong arming the sick and vulnerable for money they didn't necessarily owe.

I'm also looking for more info on the incentives held out to the "embedded" Accretive employees collecting credit card -- and patient -- information at the ER. One instance was getting to throw a pie in a manager's face if you were the top collector. Is that now open to all of us Fairview patients? I might put my pie in a concrete shell. It would, of course, be "a mistake" though.

Golly! I'm shure it's just a coincidence that top executives at Fairview happened to have sons who worked for Accretive Health. I think it's time for some resignations.

this situation is just another symptom of the depth of illness that has stricken the American health care industry.

The children of two senior Fairview officials leverage their DNA to score a sweetheart deal for their employer. Doesn't anyone see a problem with that?

The Fairview Board seems to be clueless as to how the management operates. What does it say about their knowledge of the companies operations if they had to hear about such an abusive program from the Attorney Generals office ? What does it say about the work culture at Fairview when its employees seem to be so scared to speak up ? What does it say about the lack of internal controls at Fairview ?

Now, You' re being warned !! So as soon you get into a Fairview Clinic and Hospital, beware, Debt collectors with the blessings of Fairview Executives will be (have been already)using any of your health or financial data against you to collect any monies. So feel "free" to speak to a nurse or doctor at Fairview!!!

I am very surprised by the poor judgment by the executives whose kids worked for Accretive and disappointed that the Board blessed this arrangement.

Nepotism is nothing new at Fairview. I've been an employee at the Riverside hospital for 6 years, and nearly every department has issues with it. Children of managers are given better positions and first dibs on any openings. I happen to work in the registration department, and one of our managers happens to be a former managers daughter, her brother and a girlfriend of a brother constantly switch to better positions without interviews for other employees. Accretive was in direct control of our department, we were pushed to collect as much as possible even though it was known that patient liability was based off of a rough estimate and that Accretive's software often gave faulty information. After it was announced that Accretive would be leaving our direct manager told us to "keep doing things as we previously were" and that collection amounts were expected to stay consistent because corporate was keeping an eye on our totals. Eustis is trying to shift blame to Accretive but Fairview (on multiple levels) was completely complicit with their practices.

In response to this statement: Eustis denied that Fairview broke any laws, but acknowledged damage to its reputation. "This isn't what we're about," he said. "We're here to provide great service and treat people with dignity and respect every day, and 99 percent of the time we think we do that." Respect should begin with your Employees so they can provide great service. Your employees are the ones providing great service. They find it very difficult doing this when there aren't enough of them and they are overworked and disrespected!

Patients are coming into Fairview Hospital under duress and Fairview - through its collections agent - descends on them like vultures. Fairview say it was a mistake. It certainly was not an honest mistake. Shame.

As a physician, Dr. Moen should resign. His case is worse than Eustis, at least the latter doesn't hold Accretive stock.

It's disappointing that Fairview's board of directors is so insensitive to public opinion and ethical guidelines they approved the incestuous relationship between its top executives and a shady bill collector. A hospital that receives taxpayer dollars should not be run like a payday loan company.

 More passive corporate speak and watering down of corporate crimes..."Mistakes were made..." This statement comes out of corporations and governments all the time. That way no one has to stand up and take blame!

"Mistakes were made." The biggest one, of course, was in getting caught.

I agree, this activity can't be explained away with a simple "oops"...these execs need to be held accountable for their indefensible actions. A large fine against Fairview, and a couple of terminated execs at a minimum.

I used to work for Fairview and left because it was the most unethical company I have worked for. Yes, they broke several laws here. First, it was a violation of HIPPA for them to release the patient info to the outside company, secondly it is a violation of the EMTALA law to force people to pay for emergency treatment before getting treated. How can the Board not realize this - Fairview crams these laws down the employees throats so they don't break the law in day to day practice, but the senior management feels it is OK for themselves to break the laws. Fairview, you are unethical, and broke the law!!! Time for the CEO to put on his big boy pants and admit he broke the law. The CEO needs to be criminally charged!!!

My son went to Fairview Southdale last September for an appendectomy and my wife was all but coerced to providing a credit card while waiting for treatment even though we have medical insurance. We were charged for a guesstimated deductible (which was finally refunded to us 7 weeks later). I couldn't believe it.

 Thank you Lori for looking out for the rest of us. I still don't like that the U of M hospital has been privatized.

Fairview spends big bucks advertising their clinics and hospitals as better than average. This sorry mess completely negates any good will they had with many potential consumers. They had lousy billing and customer service 20 years ago and apparently still have bad billing. I just retired and was considering changing my clinic and hospital for convenience. I will not do business with Fairview until the upper management is changed or apologizes.

This REALLY ticks me off. I am one of those lucky folks who had their personal information put at risk by these leeches. And now it turns out they are behind the recent turn towards the Draconian at Fairview?? Beautiful. Fairview should thank its lucky stars there are some poor fools out there like me who have regulated insurance that insures I cannot go to another care system.

The story of Lori Swanson's action against Accretive made the front page of the NY Times on line this afternoon, and provoked hundreds of comments. This truly strikes a nerve.

Maybe hospitals could curb their advertising, excessive building upgrades and focus on providing direct patient care.

It is very much illegal for any hospital or clinic to demand money up-front for services that haven't been given. I have worked in healthcare for 10 years and that is a HUGE no-no. I've had my own problems with Fairview's billing practices and illegally balance billing me for what insurance didn't cover that wasn't part of the co-pay or deductible. I had to threaten to sue them to make them back down and hire an attorney to sort it out. I have refused to go to Fairview for healthcare ever since and I tell everyone I know how deceptive they are.

Fairview tried the same thing on us when doing a "pre-admittance" information screening regarding my wife's cancer surgery. When they pushed for prepayment of our portion of the bill ( we are fully insured with pretty good insurance)and balked when I said I would pay afterwards, I told them that either they dropped the issue right then or the next conversation would be with my attorney.

Same thing happened to us last January 2011 - I had to take my son to the ER for a split lip; in rolled the guy with computer on the tall wheeled podium. "Here's the estimated charge for today's visit; credit card please" - they get you when you are vulnerable and this time zapped almost a thousand bucks out of my credit card. I didn't like the practice - hadn't even been seen by a physician and here's your bill. Pay it! Nice. Glad to see that they've been booted out. Really, I wasn't inclined to go back and use their ER services again if the need arose because of that.