By Phil Galewitz, Kaiser Health News
When the oversized postcard arrived last August from Provena St. Joseph Medical Center promoting a lung cancer screening for current or former smokers over 55, Steven Boyd wondered how the hospital had found him.
By Brett T. Roseman, for USA TODAY
Steven Boyd of Joliet, Ill., and wife Karol received a direct mailing from their local hospital offering lung scans.
By Brett T. Roseman, for USA TODAY
Boyd, 59, of Joliet, Ill., had smoked for decades, as had his wife, Karol. Provena didn't send the mailing to everyone who lived near the hospital, just those who had a stronger likelihood of having smoked based on their age, income, insurance status and other demographic criteria. The non-profit facility is one of a growing number of hospitals using their patients' health and financial records to help pitch their most lucrative services, such as cancer, heart and orthopedic care. As part of these direct mail campaigns, they are also buying detailed information about local residents compiled by consumer marketing firms — everything from age, income and marital status to shopping habits and whether residents have children or pets at home. Hospitals say they are promoting needed services, such as cancer screenings and cholesterol tests, but they often use the data to target patients with private health insurance, which typically pay higher rates than government coverage. At an industry conference last year, Provena Health marketing executive Lisa Lagger said such efforts
had helped attract higher-paying patients, including those covered by "profitable Blue Cross and less Medicare." While the strategies are increasing revenues, they are drawing fire from patient advocates and privacy groups who criticize the hospitals for using private medical records to pursue profits. Doug Heller, executive director of Consumer Watchdog, a California-based consumer advocacy group, says he is bothered by efforts to "cherry pick" the best-paying patients. "When marketing is picking and choosing based on people's financial status, it is inherently discriminating against patients who have every right and need for medical information," Heller says. Deven McGraw, director of the health privacy project at the Center for Democracy and Technology in Washington, says federal law allows hospitals to use confidential medical records to keep patients informed about services that may help them. "You want health providers to communicate to patients about health options that may be beneficial," McGraw says. "But sometimes this is about generating business for a new piece of equipment that the hospital just bought." Using such information for marketing "creeps closer to the line" between what is legal and what is not, she says. Hospital officials such as Denise Beaudoin of Detroit's Henry Ford Health System say what they do is legal and that the sophisticated targeting approach — called "customer relationship marketing" — simply helps them deliver information to those most likely to use it. They say hospitals are adopting strategies used for decades by the retail, travel and communications industries, which have flourished with the growth of online companies such as Amazon and Google. For example: Buy a book on Amazon and it will suggest a title with a similar subject. Search for information on Alaskan vacations on Google, and an ad pops up for a cruise line. At a time when government and private insurers are tightening reimbursements, more hospitals are turning to similar approaches to drive admissions. An estimated 20% now use the strategy, including large academic medical centers and large chains, such as HCA, based in Nashville, and Trinity Health, based in Novi, Mich. The trend is expected to accelerate as more hospitals adopt electronic health records, says Guy Miller, a Chicago health care consultant. Putting patient data to work Tess Niehaus, vice…