Dr. John Happel | Sep 22, 2018 | 0
Vein Centers in Pittsburgh Still in Private Practice – Happel Laser & Vein Venter
Pittsburgh Vein Centers Come in All Kinds of Flavors
Your Vein Centers Options Are Franchises, Hospital-Owned, and Private Ownership
This article was written to help you to choose the right type of Pittsburgh vein center for you.
Let’s discuss the three different vein center options available to you if you have varicose veins.
Where you go to have your veins treated will determine how you are treated and your final cost.
Don’t assume that all vein centers will treat you the same and cost the same even when insurance is involved.
Patients have sent me their final bills after they went to other vein centers for a more convenient location and were shocked at how much more the other vein center charged them.
In today’s vein center market, the red flags are redder than ever.
Hospital Owned Vein Practices
In Pittsburgh, this pertains to the vein practices owned by UPMC and those owned by Allegheny Health Network (which is actually owned by Highmark Blue Cross/Blue Shield.)
Unbelievably, these two behemoths have dominated the Pittsburgh area to the point that you actually cannot buy health insurance from any other insurance company unless your employer buys your plan for you.
In other words, if you buy your healthcare yourself, Aetna, United, Cigna, Coventry, Humana and all other plans are closed to you.
The guiding principle with Pittsburgh’s two dominate health systems is that one or the other of these two health systems first buys all of the private community practices.
The practice buying binge by these hospital-owned healthcare companies continues today.
Then they can direct all of their patients to their own specialists under contract within their hospital system (either the UPMC or the Allegheny Health System).
The referral patterns for patients in Pittsburgh are polluted.
In other areas of the country, it’s not much better.
In Florida, the Broward Health system paid $70 million to settle allegations of improper financial relationships with doctors.
In these types of relationships, it is improper to give doctors incentives to generate money.
Doctors are pressured to refer within the same group and to increase volume if they lag.
It has been said that when these huge hospital systems and their hospital administrator “suits” talk about patients, you can replace the word, patients, with the word, money.
Financial incentives in these types of medical systems and vein practices to generate revenue is widely accepted as unethical.
It eliminates competition for people with varicose veins and limits your choices of vein doctors significantly.
Primary care doctors can be fired if they refer to a specialist who is not in the same hospital owned practice as them.
It also encourages kickbacks, referrals to low quality specialists (as long as they have sold their practices to your hospital owned healthcare system), and can lead to unnecessary testing and unnecessary procedures.
The contracts that the doctors in these systems sign are driven by referrals.
Dr. Michael Reilly, a Fort Lauderdale, Fla., orthopedic surgeon, does not believe this is good for physicians, patients or society.
“My wish would be that the hospital-physician employee contract would go away,” said Reilly, now retired and entitled to $12 million of the whistleblower settlement. “You could pick just about any hospital, and I will tell you there is a component where that contract is driven by referrals.”
Read about this whistleblower doctor who warns about hospitals hiring physicians.
UPMC adds unnecessary facility (hospital) fees for to your final bill when you have your veins treated by their doctors.
They use special hospital codes that end up costing patients more because they take their patients to more expensive facilities like Magee Women’s Hospital for their vein procedures.
They have added wording to their forms so that these additional and unnecessary fees are not as hidden as in the past.
UPMC is the leading employer in the state of Pennsylvania.
Politicians in our area have tried to limit these kinds of behaviors but have failed.
What can you do to stop this?
Ask your vein doctor who they work for.
If the hospital owned vein doctor recommends a procedure or testing, always consider a second opinion if you have varicose veins.
Private or Independent Vein Centers
These are the Pittsburgh vein specialists who have not sold their practices to either UPMC or Highmark.
Independent vein doctors aren’t pressured to generate revenue by ordering procedures.
This is a freedom not shared by the vein doctors who are under contract by the big two.
Their vein specialists must meet their quota.
Essentially, they work on commission and must generate a fixed number of procedures which is directly related to their paycheck which implies has financial benefit for the volume of cases that they perform.
Never ask a barber if you need a haircut.
Vein Center Franchises in Pittsburgh
On June 23, 2017, the Circulatory Centers of Pittsburgh declared Chapter 11 bankruptcy and went out of business.
They owed millions of dollars to the Third Fifth Bank and other lending institutions.
The Justice department had a $38 million dollar claim against them for false claims in health care and was also actively investigating all of their vein centers and practices.
Regarding this case, U.S. attorney Brady said,
“Inflating the cost of health care services defrauds taxpayers and depletes the limited funds available to provide medical care to deserving patients. Today’s settlement signals our commitment to aggressively pursue entities and individuals who attempt to cheat American taxpayers.”
In December 2017, a special trustee, Natalie Lutz Cardiello, was appointed by the court.
The court stated that the debtor’s (the Circulatory Center’s) principles were advancing their own personal interests at the expense of the creditors (the banks that the Circulatory Centers has borrowed millions from).
The Circulatory Centers were finally bought by U.S.A. Vein Clinics and is under new management.
Is this the type of environment where you want to have your vein care?
Vein franchises and med spas that treat venous disease are like yellow jackets scouting a picnic.
Final Thoughts – Vein Centers Are Everywhere
There are three different types of vein center ownerships in Pittsburgh.
Your choices are:
- insurance companies owned (like UPMC and Allegheny Health Network)
The Happel Laser & Vein Centre in McMurray, PA is independent and privately owned.
It accepts assignment and is in-network with all of the major commercial health care insurances including both UPMC and Highmark.
It is the only vein center in Pittsburgh in Pittsburgh to be granted accreditation for varicose veins treatment and the fourth vein center in the United States to achieve this distinction.
UPMC and AGH are not accredited vein centers and are insurance company and hospital owned.
USA Vein Clinics is a national franchise which bought the bankrupt Circulatory Centers.
It is a big unknown in this area.
On the other hand, Dr. Happel is well established and has over 32 years of experience specializing in veins.
He was the first physician to perform laser varicose vein surgery in Pittsburgh.
The Intersocietal Accreditation Commission verifies that John Happel MD has voluntarily undergone a rigorous review including on site examination of his vein facility by a national panel of vein experts.
It is a “seal of approval” that a vein center’s safety and qualifications have been comprehensively evaluated.
Dr. Happel received his vascular surgery training and vascular surgery fellowship at the Mayo Clinic.
He is Board Certified in Vascular Surgery and specializes in the treatment of varicose veins.