It has been nearly 15 months since HCA’s National Patient Account Services (NPAS) began offering account receivables management services to non-HCA-affiliated hospitals, and so far Curtis Warfield, the company’s chief executive, is pleased with the results.

“There were a lot of naysayers that said some hospitals wouldn’t want to use the (accounts receivables management) services of another hospital,” Warfield recently told insideARM. “That has not been the case.”

Warfield said that more than 10 percent of the Louisville, Ky.-based company’s revenues come from non-HCA hospitals. And he believes NPAS can double its external customer base each year for the foreseeable future. That’s because self-pay accounts are growing faster than most hospitals, large and small, can add personnel and technology to effectively management them and margins are deteriorating.  

A subsidiary of privately-held HCA Corp., owner of the largest hospital chain in the U.S., NPAS decided to extend its ARM services to non-HCA hospitals after a consultant’s review showed hospitals needed its services.  Warfield said clients are comfortable turning to NPAS for help with their receivables because the company handles medical accounts only, is familiar with industry regulations, — such as Health Insurance Portability and Accountability Act (HIPAA) — and has the technology to efficiency manage accounts. 

“Investing in a robust infrastructure is cost prohibitive,” Warfield said. “In order to do so, a small hospital system would have to take money out of patient care and put it in the back office.  With us, they can keep their money and invest in operations and still get the functionally of a large hospital system. “

Warfield said NPAS is looking into the feasibility of extending its services to other health care providers, including physician groups. But whether or not it does service physician groups, he believes the business is posed to grow because more people are becoming uninsured or underinsured as consumer-centered health plans become more widely used.

“The market is huge and the goals we set for ourselves, we’re doubling it,” Warfield said. “It’s a business nobody wants to see grow, but it’s growing.”


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