HCA Healthcare’s “activation” fees for trauma care in Georgia are double those at other hospitals in the state, according to a Kaiser Health News report this week.

This story also appeared in Georgia Health News and Kaiser Health News

The company’s Georgia fees of about $15,000 are actually lower than those in most other states where HCA operates trauma hospitals, the KHN analysis found. Those activation fees elsewhere run as high as $50,000 per patient and are sometimes 10 times greater than those at other hospitals, according to publicly posted price lists.

HCA runs Memorial Health in Savannah, as well as hospitals in Dublin, Waycross, Vidalia and Augusta.

The KHN report, quoting corporate officials, said such charges have made trauma centers, which were once run mainly by established teaching hospitals, a key part of HCA’s growth and profit-generating strategy.

Now the biggest U.S. hospital operator along with the Department of Veterans Affairs, HCA has opened trauma centers in more than half its 179 hospitals nationwide and says it runs 1 of every 20 such facilities in the country.

The company recently reached an agreement to sell its Rome hospital to AdventHealth. It’s also selling four hospitals — two in Macon and two in different parts of metro Atlanta — to Piedmont Healthcare.

Defining trauma

Trauma patients are typically people severely injured in automobile accidents, falls, stabbings or shootings.

State or local regulators confer the designation “trauma center” on a facility, and that status allows lucrative reimbursement, including activation fees billed on top of regular charges for medical care. A trauma activation involves paging a number of hospital staff to go to the emergency department as quickly as possible.

Who pays, for what

The bills for all this — reaching into tens of thousands of dollars — go to private insurers, Medicare or Medicaid, or the patients themselves.

Hospitals defend trauma team activation fees as necessary to cover the overhead of having a team of elite emergency specialists at the ready, KHN reported.

Adam Landau, an HCA spokesman, told GHN that for trauma activation, patients pay co-pays and deductibles according to their insurance plans, “while uninsured patients receive a 100 percent discount on trauma activation.’’

HCA “has basically taken a position that all of their hospitals should be trauma centers,” said Dr. Robert Winchell, describing conversations he had with HCA officials, KHN reported. Winchell is a trauma surgeon and former chairman of the trauma evaluation and planning committee at the American College of Surgeons.

This story available through a news partnership with Georgia Health News.

Andy Miller is the founder of Georgia Health News, a nonprofit news site dedicated to reporting on health policy for Georgia's citizens.