In most industries, it's standard operating procedure to target your most profitable customer segments and find a way to capture them. In healthcare, though, it's unusual for executives to take this approach. In fact, cherry-picking profitable patients and screening out unprofitable ones runs counter to many healthcare providers' missions and may be illegal, notes Scott MacStravic in HFMA Views, a publication of the Healthcare Financial Management Association. Still, there are at least two service lines where it's not only ethical, but necessary to consider the profit motive, MacStravic suggests. First, because customers for occupational and corporate health programs are businesses, it makes both moral and business sense to focus on profitable relationships. Another option, though a more controversial one perhaps, is to manage "proactive health" programs such as diabetes management for patient behavior, selecting for patients who are likely to cooperate and and ejecting patients that don't comply with the prescribed regimen. Programs of this type can't work unless resources are focused on the most profitable participants, MacStravic contends.

To review MacStravic's whole argument:
- read this article in HFMA Views