Is Accretive Health in a death spiral?

Accretive Health, the Chicago-based revenue cycle management firm accused of harsh billing and collection practices, such as bedside collection visits for ER patients, now faces a money-showing problem of its own.

Accretive hasn't released any earnings statements since the third quarter of 2012. Given it is a publicly-traded company, this is known in financial parlance as a bit of a problem.

Accretive has formally notified the Securities and Exchange Commission (SEC) on three separate occasions about delays with its earnings reports. On Dec. 30, in an astonishing admission to the SEC, it stated: "Investors should not rely on the company's financial statements for the years ended December 31, 2009, 2010 and 2011 and the quarterly periods within those years, and for the first three quarterly periods for the year ended December 31, 2012 and any of the company's other prior financial statements."

Meanwhile, Accretive struggles with sifting financial fact from fantasy. It announced last week that it will miss the March 19 deadline it had set to release new and restated numbers. It failed to provide a new date for when it will release the numbers, although Accretive said in a statement that it hoped to do so "as soon as possible."

I can imagine the company's response if a patient under care at a facility where Accretive held sway gave a similar answer. The patient would likely been left on the operating table until he or she--or a loved one--opened up their wallet. 

Accretive's can-do spirit in patient collections apparently didn't stir the company's chief accounting officer, who recently announced his departure because he doesn't want to relocate to Dallas. The company is moving some operations both there and to Detroit to cut costs.

Read into that what you will, but given the recent winter in the upper Midwest, anyone turning down a chance to move 1,000 miles to the south sounds a little fishy to me. That he's also the guy in charge of the books for a company that hasn't disclosed any financial information for five consecutive quarters is probably just a coincidence.

I can only imagine his response if the company ordered him to move to Detroit.

Meanwhile, the SEC is tired of Accretive's non-accretiveness. It announced the the New York Stock Exchange recently delisted the company's stock and it is now trading over the counter.

The company did assure its remaining shareholders that it still is sitting on more than $200 million in cash. In other words, it has enough money to paper over any problems connected with the fact it never issued an accurate financial report and apparently pay for a fine, which included a ban from the the entire state of Minnesota.

I've slammed Accretive in this space for its past conduct to the point where company officials asked I meet with their CEO and an employee manning its booth at last year's Healthcare Financial Management Association identified me on sight. That's no mean feat, given the vendors section takes up something like 347 football fields, a scale that should render me just another face in the crowd.

Mary Tolan moved on from Accretive's CEO post last year. However, I wonder if representatives of Accretive, a company finally facing its comeuppance, will attend the next HFMA conference in Las Vegas. 

If they are, I intend to ask for their contact information. Who knows--I may be the lucky guy who gets the first shot to see what this far less brash and much shyer company is now all about. - Ron (@FierceHealth)

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