Hospital chain Health Management Associates has vowed to take a tougher line in collecting from self-pay patients, in a move designed to rid the chain of a reputation for being less aggressive than its competitors. This week, the chain told the investment community that this loss comes partly from a higher volume of uninsured patients attracted by its generosity.

HMA, which has 59 hospitals, has taken a beating financially over the past year. Despite an 8.2 percent gain in revenue, net income for the third quarter ended Sept. 30 was $30.5 million, less than half of the company's $74.4 million net income for the third quarter of 2006.

HMA, which already gives uninsured patients 60 percent discounts off of gross charges, will now begin asking patients to sign a promissory note before leaving the hospital and moving their accounts to collection agencies sooner.

To learn more about HMA's challenges:
- read this Modern Healthcare piece [1]

Relate articles:
- FL hospital sued over sale of $1.9B in bad debt article [2]
- Hospitals collecting patient bills up front article [3]