According to a new Health Affairs study doctors who partner with friendly general hospitals or national firms to invest in specialty facilities may lose control of them or may be indirectly affected by a volatile stock market, write the authors of the study, led by Lawrence Casalino, MD, a health studies researcher at the University of Chicago.
The authors add that specialty facilities could face a difficult future if Medicare payment rates for the lucrative services they cover fall, which has occurred for ophthalmology, or if they face stringent regulations, which Congress is expected to consider in the next few years.
They warn that hospitals removing staff privileges from investing physicians or pressuring health plans to refuse contracts with such facilities face possible antitrust litigation or the wrath of organizations like the AMA, which has been litigating against hospitals' removal of physicians, known as "economic credentialing."
On the other hand, "if a hospital cooperates in joint ventures, it risks alienating physicians who are not involved, losing volume at its own facilities and damaging its credit rating as a result of lenders' concerns about hospital financial liability for ventures that fail," the authors write.
The new Medicare legislation imposes a qualified moratorium on new specialty hospitals while two separate federal panels review the industry's impact on general hospitals and other issues.
Ohio’s House of Representatives recently passed House Bill 71 that addressed a number of the study’s concerns including prohibiting of the use of economic credentialing against physicians with ownership interests in specialty hospitals. The bill has been referred to the Ohio Senate Health, Human Services and Aging Committee.
Watch for updates on this issue in upcoming AMC/NOMA publications.