Hospitals Are Using Confidential Medical Records To Target High-Paying Patients

Source: http://www.businessinsider.com/hospitals-are-using-confidential-medical-records-to-target-high-paying-patients-2012-2

Hospitals are increasingly milling their patients’ confidential medical records to target their promotional mailings for services, reported Phil Galewitz of USA Today.

It’s not illegal, but the practice doesn’t sit well with consumer advocacy groups who point out that many health care providers are choosing to ping patients with better insurance coverage.

That creates a sort of indirect discrimination, as hospitals make it harder for consumers with less insurance to learn about services they may very well need.

To target the ads, hospitals determine the likelihood that patients would need certain services based on age, income and insurance status. Hospitals have said they target patients with private insurance because the companies tend to pay higher rates than government-backed plans like Medicare and Medicaid.

The mailings also advertise a variety of tests, such as screenings for cancers and cholesterol, which are generally more expensive.

As record numbers of Americans go without health insurance, hospitals targeting consumers who are more capable of shelling out money for services has been an inevitable outcome, along with soaring health insurance premiums (Read why the rich are building their own hospitals.)

To make matters worse, employers are also reducing health insurance benefits in the workplace.

As we recently reported, one in five Americans are experiencing difficulty paying off their medical debt, while 25 percent have considered filing for bankruptcy because of rising medical bills. 

Though targeted mailings might place others without insurance at a disadvantage, hospital officials insist they target patients who pay more to make enough profit to serve everyone.

Now learn 6 ways to arm yourself against rising health insurance costs >

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Of course, there are different types of record labels. A major label, such as EMI, has a lot more money to throw around and can make more promises, but contracts with majors can end up with artists further in the hole due to these deep pockets. As Bonacci told me, “There’s more risk. There’s more fuel to propel you forward up front, but that’s no guarantee.” That same fuel could blow up in your face. We’ve seen how bands who don’t hit it big can end up “owing” their major label hundreds of thousands of dollars, after all.

Indie labels (true indie labels, not boutiques under the umbrella of a major) have less resources and therefore will give bands less to recoup. Indies also will often offer the artist a chance to interact with top brass, something that is almost never done at a major. Indies are presumably owned by passionate music fans rather than gigantic multinational holding companies, which is important when a band needs to know that a label is 100% behind them, according to RRR’s Bonacci.

And signing to an indie instantly connects you to that labels fans, Bonacci says. “Nobody really cares about Sony records or Universal. You don’t seek out stuff that’s being released on Universal as a fan. Independent labels, be it Domino or SubPop or whatever, those labels have fans.”

Indie labels seem to have a better chance of adapting and surviving in tumultuous times. Since for the most part they’re private companies with few employees, they’re able to make drastic changes in their business models much more quickly than major labels. But that doesn’t mean they’ll all survive; famed indie label Touch and Go closed down last year, and in addition to repping bands such as TV on the Radio, Ted Leo and the Pharmacists, !!! and Blonde Redhead, they also handled distribution for other venerable indies such as Drag City, Kill Rock Stars, Jade Tree and Merge. It was a huge blow to the indie label scene.

Getting a Cut of Everything

The way labels are moving to stay alive is by becoming involved in the places that bands still make money, such as touring and merchandising. Traditionally, labels only made money off records sold, while any profits made from t-shirts or posters sold on the road went to the band. After all, if the label just owns the master recordings, it can only make money off the sale of said recordings, not any ancillary profits that come from things like touring.

But now some labels are pushing what are called 360 deals, which involve them in virtually everything an artist does. One of the most famous 360 deals was EMI’s 2002 deal with Robbie Williams, which was worth a whopping £80 million, giving EMI a piece of basically everything that Williams touched. That didn’t go so well, with Williams threatening to withhold albums from the label and trying to get out of his contract. But last week, according to UK trade paper Music Week, Williams’ manager Tim Clark publicly came out in support of the embattled label, saying, “My own view is Citigroup would be mad at this stage not to keep EMI on as a going concern. It just would be bonkers.”

In any case, 360 deals and general diversification are what big labels such as EMI are looking to move into, according to Billboard’s Glenn Peoples. “They’re definitely diversifying and they’re actually getting into agencies, artist management, concert promotion. There’s really no area that the four majors are not pursuing right now.”

These deals make the most sense for huge acts with lots of opportunities for branding and licensing. You’ve seen it in action here on Giz, in fact, with Dr. Dre’s Beats headphones and Lady Gaga’s new Creative Director “job” at Polaroid. Both those acts are signed to Interscope, a sub-label of Universal that’s clearly pushing artists towards these new revenue streams. But many smaller acts are still reluctant to give a label a slice of the entire pie with such a wide-reaching deal.

The fact of the matter is that bands do still need someone working for them, 360 deal or not. For some bands, just having a small team of a dedicated manager, publicist and lawyer who can handle the nitty-gritty of online sales, tour organization, merchandising and marketing will be enough for them. But many can still benefit from the huge networks that labels have with their contacts in every facet of the industry. Sure, you can print your own t-shirts, but a label with contacts with clothing manufacturers, stores and distributors can make that process a lot easier. And just how much of this work do you want to do yourself?

360 deals don’t make sense for all bands; Ra Ra Riot manager Roth isn’t sold on them. “A lot of labels are also now branching into management because the manager is involved with everything going on with a band. Labels will try to be like a full-service company to a band, but I don’t think it’ll be very popular.” He worries that bands will be setting themselves up to be taken advantage of even more by labels if they give up merchandising and touring profits to them. Having an independent team working for a band and playing middleman between them in the label makes sure there’s someone deeply involved in “business stuff” that still has their best interests at heart.

And it makes sense that a manager would be wary of labels moving into their territory, but there’s still a distinction between label and manager with these deals. “For example, a new artist signed to a multi-rights deal may use the major label’s merchandise company and e-commerce division in addition to its publishing and recorded music companies,” Peoples says. “In the past, a manager could pick and choose which merch, e-commerce, publishing and record companies it wanted to work with. Now they’re more likely to be under the same umbrella.”

Sometimes, a band’s management team can replace what a label does entirely. Just yesterday, OK Go announced it was splitting with EMI, whom they didn’t have the greatest relationship with, to strike out on their own with a new company called Paracadute. Paracadute is basically OK Go’s own team to handle management, promotion and distribution of their records. “The things that a major has to offer above and beyond anybody else are the things that OK Go really didn’t need so much,” Peoples says. “And that’s radio promotion and access to brick and mortar retail. If you’re going to create nearly all of your consumer awareness through cheaply made YouTube videos, you don’t need this big promotional and distribution system behind you.”

But not all bands can do what OK Go has done. The digital world looks a lot more accessible when only viewed through the lens of rock acts. “If you’re an R&B act, if you’re a straight up pop act, a country act, you’re going to need radio and you’re going to need brick and mortar retail, and that’s not going to change anytime soon. Things are changing definitely for alternative rock, rock and indie, but some genres sell a lot better in digital than other genres.”

But clearly, the money that’s to be made in music is no longer just in album sales. And bands seem to be presented with a choice: they can either allow labels to become more involved in everything that they do, and give up money that used to go exclusively to them in the process, or strike out on their own. Either way, they’ll entering a landscape where getting their song on Gossip Girl for 40 seconds is more important than any amount of FM radio play, where getting a music video posted to Stereogum is more important than getting it on MTV and where you make more money touring behind an album than selling that same album.

And in order to prove to artists that signing with a label is a better idea than going out on your own, they’ll need to make big changes; bigger than they’ve made so far. “It might be how an addict ends up turning his life around,” Peoples says. “He’s gotta hit rock bottom. And I dunno if the record industry has hit rock bottom yet, but maybe that’s what’ll need to happen for there to be really big change.”

But at the end of the day, the saving grace of record labels might be a lot more basic than who gets what percentage of merchandise or who deals with distribution. The big question is this: do bands really want to try to make it completely on their own? As Bonacci says, “I don’t necessarily want to have all that nitty-gritty stuff to worry about. I’d rather just worry about making music. I don’t want to worry about numbers or distribution or marketing or publicity or anything like that. That sounds like a desk job. I used to have a desk job, that’s why I’m playing music. Now look at me. I sleep on couches.”

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