A recent study, released by the Center for Studying Health System Change, states general hospitals fear that an increase in physician-owned specialty hospitals may gain the most profitable patients, leaving the sickest and most costly patients to general hospitals. According to the study, three factors appear to be driving the specialty hospital growth.
Private and government insurers may be paying too much for certain cardiac and orthopedic services, while underpaying for other services, prompting investment in specialty hospitals focusing only on profitable services.
Physicians' desire for more control over their working conditions, including staffing levels, scheduling and equipment purchases
Physicians' desire to increase their income by generating more professional fees through increased productivity and capturing a portion of facility profits if they were owners.
The growth of specialty hospitals has put this issue on the minds of state and federal policy makers. Existing federal law limits physicians' ability to refer Medicare and Medicaid patients to health care facilities, such as clinical laboratories, in which they have a financial interest, but the law exempts physician investment in whole hospitals. Recently introduced federal legislation would continue to allow physicians to refer patients to a hospital in which they have an ownership interest, but only if the interest was purchased on terms also available to the general public. Other proposals include: requiring specialty hospitals to accept Medicaid and indigent patients; requiring the same quality and patient-safety standards for specialty and general hospitals; requiring specialty hospitals to have full-service emergency departments; and enacting certificate-of-need laws aimed at curbing excess capacity.
Complete findings of the study and more in depth information may be found at the Web site for the Center for Studying Health System Change at http://www.hschange.org .