Oftentimes, there exists a contentious feud between supporters and objectors to specialized institutions that cater to a lucrative payer mix. Despite ongoing criticism that specialty hospitals that focus on profitable cardiac and orthopedic services would divide the haves and have-nots, a recent study found that isn't necessarily the case.
"Although the specialty hospitals initially presented challenges to general hospitals, general hospitals didn't feel the impact in their ability to care for financially vulnerable patients," says Alwyn Cassil, director of public affairs at HSC.
Some speculated that these specialty services cater to an elite payer mix, that is, low-acuity patients that can afford elective surgeries from Medicare and private insurance. They argued that general hospitals were left to take care of under- or uninsured patients, hurting their revenue. However, the study found that specialty hospitals do not pull patients, or physician specialists, from general hospitals or safety net hospitals.
About the study
Researchers surveyed three markets in Indianapolis, Phoenix, and Little Rock, Ark., between March–June 2008. Although "these three markets are not representative of all areas that have specialty hospitals," admits Cassil, the study does present interesting data about what is on the minds of leaders at general hospitals.
One survey respondent said if he were to name the top five challenges to general hospitals, specialty competition wouldn't be on that list, according to the study. General hospitals are worried more about the economy than patient or recruitment competition from than their specialized counterparts. They witnessed little change in patient acuity because of a national rise in uninsured patients overall rather than losing out to specialty services.
Government intervention
In the past decade, hospitals have elected to pursue profitable service lines with specialized care. In 2003, Congress placed an 18-month Medicare moratorium on physician self-referrals to new specialty hospitals with the goal of halting facilities in which physicians had a financial interest. However, this "paradoxical step" created disproportionate payments for existing physician-owned institutions, according to Richard Rohr, MD, MMM, FACP, director of hospitalist programs at Guthrie Healthcare System, Sayre, PA and blogger for HospitalistLeadership.com.
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Massachusetts-based Partners HealthCare narrowed its loss in the second quarter, but still reported a $151 million deficit through the first half of its 2009 fiscal year, largely because of investment declines. The slumping investments, which are used to support expansion, have forced the healthcare system to scale back on a five-year building program across Eastern Massachusetts.
California health regulators fined Kaiser Permanente's Bellflower hospital $250,000 for failing to keep employees from snooping in the medical records of Nadya Suleman, the mother who set off a media frenzy after giving birth to octuplets in January. The fine is the first monetary penalty imposed and largest allowed under a new state law enacted last year after widely publicized violations of privacy at UCLA Medical Center involving Farrah Fawcett, Britney Spears, Maria Shriver, and other celebrities.
U.S. HealthWorks Medical Group has acquired five Medero Medical centers in Florida. The California-based company acquired two centers in Orlando, one in Leesburg, and two in Tampa. The medical centers focus on providing injury and illness diagnosis and treatment, preventive services, and other occupational health programs. Terms of the transaction were not disclosed.
The waits to see Boston dermatologists, obstetrician-gynecologists, and orthopedic surgeons for routine care have grown longer—to as much as a year for the busiest doctors. A study of five specialties shows that the wait for a nonurgent appointment in the Boston area has increased in the past five years, and now averages 50 days. Patients in Boston and other areas of Massachusetts for years have faced notoriously long delays, according to earlier surveys of physicians' offices. A number of factors contribute, doctors said, but the 2006 health insurance law which has required hundreds of thousands of state residents to obtain coverage probably has worsened the waits.