Back to Basics
This is about efficiency, remember. This discussion focuses on specialty hospitals, and in particular, an article by Stuart Guterman in Health Affairs, 25:95-106, 2006. Many such have existed for some time, without controversy (childrens hospitals, psych hospitals, etc.). The current reason for concern is over specialty hospitals that are owned by physicians and focus on procedures (orthopedics, surgery, cardiology, etc.). These are opposed by general hospitals on the grounds that they cherry pick profitable cases and thus detract from hospital revenue. These concerns were largely debunked by the Medicare Payment Advisory Commission, but Congress and CMS nevertheless imposed a moratorium on further licensing of Specialty Hospitals. One additional concern is that physician-owners “will be torn between considerations of clinical appropriateness and financial benefit.” This may be a problem with single owners of a facility, but personal experience in ambulatory surgery centers suggests the opposite when ownership is diluted. “This isn’t the dressing I would prefer, but I know it’s cheaper, so I will use it.” Amazing what a little profit motive will do to reduce costs of care.
Just like ambulatory surgery centers, specialty hospitals represent change and are therefore opposed by all who benefit from the status quo (hospitals, universities, foundations, etc.). Specialty hospitals probably represent a more efficient means of providing healthcare, and one would think they would be welcomed into the provider mix. Even CMS concluded that “although specialty hospitals do not generally treat uninsured or Medicaid patients, the taxes they pay more than make up for that difference.” Not wanting to be accused of rational thinking, CMS is now busy devising restrictions to further inhibit the development of specialty hospitals. And healthcare costs continue to rise. Gee, wonder why.
Just like ambulatory surgery centers, specialty hospitals represent change and are therefore opposed by all who benefit from the status quo (hospitals, universities, foundations, etc.). Specialty hospitals probably represent a more efficient means of providing healthcare, and one would think they would be welcomed into the provider mix. Even CMS concluded that “although specialty hospitals do not generally treat uninsured or Medicaid patients, the taxes they pay more than make up for that difference.” Not wanting to be accused of rational thinking, CMS is now busy devising restrictions to further inhibit the development of specialty hospitals. And healthcare costs continue to rise. Gee, wonder why.
