Reliance on high-tech and high-turnover leading to lawsuits in ‘hospitalist’-heavy San Antonio

The medical examiner’s office also took the unusual step of writing that Watson’s manner of death was “unclassified” because Texas does not have a category for “medical misadventure,” another term for a medical error or mishap, according to the lawsuit.

Adding insult to injury is the fact that IPC billed Medicare for a hospital visit that never occurred, Rhodes said. “And if they didn’t see her and they billed for it, that’s fraud, isn’t it?” Rhodes asked Dr. Virlar in a deposition.

“Yes,” responded Dr. Virlar, according to court records.

In 2010, the U.S. Attorney’s Office for the Northern District of Illinois announced it was investigating IPC for alleged fraud related to IPC’s Medicare billing practices. After informing investors of the federal investigation, the stock price fell about four dollars, though it has since rebounded. IPC filings show that, in 2006 and 2010, it paid out $750,000 and $1.3 million in professional liability settlements after maxing out liability insurance for those years. Its current filings alluded to the possibility of additional lawsuits on the horizon.

The federally-funded UTMB research is part of a greater effort to reduce wasteful spending in Medicare and improve America’s health care system, which has the highest costs in the world, yet our rate of life expectancy ranks near the bottom of developed nations. “In the past, readmission was bad for the patient, but, what the heck, it was more money,” Maynard said. “Even if we (repeal) health care reform, the train has left the station. The future is definitely a more aligned model, so that medical centers will experience big losses if readmission rates are really high.”

That may yet depend on the direction of the political winds and the growing power of corporate health care as more publicly traded companies buy up smaller medical practices in a variety of specialties. “The biggest problem I see is that we’re commoditizing health care for the sake of efficiency,” said Dr. Fred Barken, an Ithaca, NY-based doctor who laments the decline of primary care physicians in the book Out of Practice. “The metrics that corporations look at are not the same criteria patients or doctors look at.”

Founded in 1995, IPC has grown by leaps and bounds since going public in 2008, when Wall Street money enabled the company to expand rapidly by acquiring smaller practices across the country. IPC-Link, its management software, is marketed as a tool that helps hospitalists gain quick access to medical records and primary care physicians. It also helps executives monitor productivity. “I know what my partners are doing; I know what I am doing. I know that if I only have 100 encounters for this month, I am going to lose money for the practice,” Dr. Adam Singer, IPC’s CEO, said in a December 2008 interview with HCPro. “I can manage my performance because I know where I stand.”

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