Maybe they’re the only ones making money playing bed-shifting games:
Hey - these authors are from the University of Pennsylvania and Penn’s profits were up by 6.5% the last fiscal year - the best performance since the Pennsylvania Health Care Cost Containment Council started keeping records in 1995. Compare this to the fact that one quarter of Western Pennsylvania’s hospitals lost money in the last fiscal year. Maybe they’re on to something. Maybe Penn needs another federal audit to make sure it isn’t committing any more health care fraud.
 
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Their hospital sounds similar to my urban academic center. No one’s intentionally stated that the goal is to shaft the urban poor in favor of the well-insured, but the policies are set up to accomplish the same thing. Patients routinely wait 48 hours in the ER for floor beds after being admitted (tying up ER beds while up to 50 patients sit in the waiting room) while direct transfers from suburban hospitals arrive on the floor. We constantly hear about how the hospital hopes to “improve the payor mix,” i.e. that they’d rather take the well-insured suburban patients over the Medicaid/insured locals who come in via the ER.