Hostname: page-component-8448b6f56d-xtgtn Total loading time: 0 Render date: 2024-04-17T11:12:54.441Z Has data issue: false hasContentIssue false
  • English
  • Français

Specialization and physician-ownership in the US hospital industry: beyond the moratorium

Published online by Cambridge University Press:  01 October 2007

KATHLEEN CAREY ,
JAMES F. BURGESS, JR  and
GARY J. YOUNG
KATHLEEN CAREY*
Affiliation:
VA Center for Health Quality, Outcomes and Economic Research and the Boston University School of Public Health
JAMES F. BURGESS, JR
Affiliation:
VA Center for Organization, Leadership and Management Research, Boston University School of Public Health
GARY J. YOUNG
Affiliation:
VA Center for Organization, Leadership and Management Research, Boston University School of Public Health
*
*Corresponding author: Kathleen Carey, VA Center for Health Quality, Outcomes and Economic Research, 200 Springs Road, Bedford, MA 01742, USA. Tel: +1 781-687-2140; Email: kcarey@bu.edu
Get access Rights & Permissions [Opens in a new window]

Abstract:

A moratorium in the US on referrals of Medicare and Medicaid patients to new cardiac, orthopedic, or surgical specialty hospitals by physician-investors was recently lifted, yet the considerable controversy stirred by this growing hospital organizational form continues. This paper calls attention to the peculiar trade-offs introduced by entry of these specialty hospitals, and highlights distinctions among their different types. New policy approaches should be open to the notion that all physician-owned specialty hospitals need not necessarily be regulated in the same way. And caution will be required not to compromise the capacity of community general hospitals to service more complex patients and to maintain the social safety net.

Type
Perspective
Information
Health Economics, Policy and Law , Volume 2 , Issue 4 , October 2007 , pp. 409 - 418
Copyright
Copyright © Cambridge University Press 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Hospital Association (AHA) (2004), Annual Survey Database.Google Scholar
Barro, J.R., Huckman, R.S., and Kessler, D.P. (2006), ‘The effects of cardiac specialty hospitals on the cost and quality of medical care’, Journal of Health Economics, 25: 702–721.CrossRefGoogle ScholarPubMed
Berenson, R.A., Bodenheimer, T.A., and Pham, H.H. (2006), ‘Specialty service lines: Salvos in the new medical arms race’, Health Affairs (published online 25 July 2006), w337-343.Google Scholar
Birkmeyer, J.D. et al. (2002), ‘Hospital volume and surgical mortality in the United States’, New England Journal of Medicine, 346: 1128–1137.Google Scholar
Chollet, D. et al. (2006), ‘Analysis of niche hospitals in Texas and the financial impact on general hospitals’, Mathematica Policy Research Inc., Washington, DC.Google Scholar
Cram, P., Rosenthal, G.E., and Vaughan-Sarrazin, M.S. (2005), ‘Cardiac revascularization in specialty and general hospitals’, The New England Journal of Medicine, 352: 1454–1462.Google Scholar
David, G. (2005), ‘The convergence between for-profit and nonprofit hospitals in the United States’, University of Pennsylvania. Available at: bpp.wharton.upenn.edu/Documents/David_AEW_paper_3_16_05.pdf, accessed 22 January 2007.Google Scholar
Dudley, R.A. et al. (2000), ‘Selective referral to high-volume hospitals: estimating potentially avoidable deaths’, Journal of the American Medical Association, 283: 1159–1166.CrossRefGoogle ScholarPubMed
Foundation for Ambulatory Surgery in America (FASA) (2006), ‘Ambulatory surgery centers, meeting America’s needs’. Available at: www.fasa.org/aschistory.html, accessed 6 November 2006.Google Scholar
Greenwald, L. et al. (2006), ‘Specialty versus community hospitals: referrals, quality, and community benefits’, Health Affairs, 25(1): 106–118.CrossRefGoogle ScholarPubMed
Guterman, S. (2006), ‘Specialty hospitals: a problem or a symptom?’, Health Affairs, 25(1): 95–105.CrossRefGoogle ScholarPubMed
Hayes, K.J., Pettengill, J., and Stensland, J. (2007), ‘Getting the price right: Medicare payment rates for cardiovascular services’, Health Affairs, 26(1): 124–136.Google Scholar
Herzlinger, R. (1997). Market Driven Health Care, Reading, MA: Addison-Wesley.Google Scholar
Herzlinger, R. (2005), ‘Testimony before the US Senate Homeland Security and Government Affairs Subcommittee on Federal Financial Management, Government Information, and International Security’, 24 May 2005. Available at: www.hsgac.senate.gov/_files/Herzlingertestimony.pdf, accessed 22 March 2006.Google Scholar
Kahn, C.N. (2006), ‘Intolerable risk, irreparable harm: the legacy of physician-owned specialty hospitals’, Health Affairs, 25(1): 130–133.Google Scholar
Leavitt, M.O. (2005), ‘Study of physician-owned specialty hospitals required in Section 507(c)(2) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003’, Centers for Medicare & Medicaid Services’. Available at: www4.cms.hhs.gov/MLNProducts/Downloads/RTC-StudyofPhysOwnedSpecHosp.pdf, accessed 22 January 2007.Google Scholar
Medicare Payment Advisory Commission (MedPAC) (March, 2005), Report to the Congress: Physician-Owned Specialty Hospitals, Washington, DC.Google Scholar
Medicare Payment Advisory Commission (MedPAC) (August, 2006), Report to the Congress: Physician-Owned Specialty Hospital Revisited, Washington, DC.Google Scholar
Mitchell, J.M. (25 October 2005), ‘Effects of physician-owned limited-service hospitals: Evidence from Arizona’, Health Affairs, Published online:w481-490.Google ScholarPubMed
Mitchell, J.M. (2006), ‘Effects of physician-owned limited-service hospitals’, paper presented at the Inaugural Conference of the American Society of Health Economists, Madison, Wisconsin, 4–7 June.Google Scholar
Moore, K. and Coddington, D. (2005), ‘Specialty hospital rise could add to full-service hospital woes’, Healthcare Financial Management, July: 84–90.Google Scholar
Pauly, M.V. and Redisch, M. (1973), ‘The not-for-profit hospital as a physician’s cooperative’, American Economic Review, 63: 87–100.Google Scholar
Sloan, F. (2000), ‘Not-for-profit ownership and hospital behavior’, in Culyer, A. and Newhouse, J. (eds), Handbook of Health Economics, Amsterdam; Elsevier, pp. 1141-1174.Google Scholar
US Government Accountability Office (2005a), Specialty Hospitals: Information on Potential Facilities, GAO-05-647R, 19 May 2005.Google Scholar
US Government Accountability Office (2005b), Nonprofit, For-Profit, and Government Hospitals: Uncompensated Care and Other Community Benefits, GAO-05-743T, May, 2005.Google Scholar