60 hospitals cancelled due to health care reform

[SilentMind]

http://cnsnews.com/news/article/64034

"The new health care overhaul law - that promised increased access and efficiency in health care - will prevent doctor-owned hospitals from adding more rooms and more beds. These hospitals are advertised as less bureaucratic and more focused on doctor-patient decision making. However, larger corporate hospitals say doctor-owned facilities discriminate in favor of high-income patients and refer business to themselves.

The new rules single out physician-owned hospitals, making new physician-owned projects ineligible to receive payments for Medicare and Medicaid patients.

Existing doctor-owned hospitals will be grandfathered in to get government funds for patients but must seek permission from the Department of Health and Human Services to expand.

The get the department's permission, a doctor-owned hospital must be in a county where population growth is 150 percent of the population growth of the state in the last five years; impatient admissions must be equal to all hospitals located in the county; the bed occupancy rate must not be greater than the state average, and it must be located in a state where hospital bed capacity is less than the national average.

These rules are under Title VI, Section 6001 of the Patient Protection and Affordable Care Act. The provision is titled "Physician Ownership and Other Transparency - Limitations on Medicare Exceptions to the Prohibition on Certain Physician Referral for Hospitals."

More than 60 doctor-owned hospitals across the country that were in the development stage will be canceled, said Molly Sandvig, executive director of Physician Hospitals of America (PHA).

"That's a lot of access to communities that will be denied," Sandvig told CNSNews.com. "The existing hospitals are greatly affected. They can't grow. They can't add beds. They can't add rooms. Basically, it stifles their ability to change and meet market needs. This is really an unfortunate thing as well, because we are talking about some of the best hospitals in the country."

The organization says physician-owned hospitals have higher patient satisfaction, greater control over medical decisions for patients and doctor, better quality care and lower costs. Further, physician-owned hospitals have an average 4-1 patient-to-nurse ratio, compared to the national average of 8-1 for general hospitals.

Further, these 260 doctor-owned hospitals in 38 states provide 55,000 jobs, $2.4 billion in payroll and pay $509 million in federal taxes, according to the PHA.

In one ironic aspect, President Barack Obama's two largest legislative achievements clashed. The Hammond Community Hospital in North Hammond, Ind., got $7 million in bond money from the federal stimulus act in 2009. It will likely be scrapped because of the new rules on physician-owned hospitals, according to the Post-Tribune newspaper in Merrillville, Ind.

These hospitals have long been a target of the American Hospital Association, which represents corporate-owned hospitals as well as non-profit hospitals.

An AHA study from 2008 says that physician-owned hospitals "lessen patient access to emergency and trauma case;" "damage the financial health of full-service hospitals and lead to cutbacks in service;" "are not more efficient than full service community hospitals;" "use physician-owners to steer patients;" "cherry pick the most profitable patients;" and "provide limited or no emergency services."

Meanwhile, one AHA fact sheet asserts that physician-owned orthopedic and surgical hospitals costs are 20 percent to 30 percent higher than average hospitals. Further, these hospitals just lead to higher profits for doctors, the AHA asserts.

"We don't cherry pick patients, period, end of story. We take patients based on their need for care, not on their ability to pay," Sandvig said. "It [the health care reform] puts control outside the hand of physicians and patients and into bureaucrats' hands really.

The Association of American Physicians and Surgeons (AAPS) is one of many organizations suing to have the law declared unconstitutional on the grounds that the federal government cannot compel someone to buy a product.

While the provision on physician hospitals is not part of the lawsuit, it will affect it, Dr. said Jane Orient, AAPS executive director.

"If the law is declared unconstitutional, then the prohibition is part of the bill," Orient told CNSNews.com. "There are vested interests in getting rid of physician-owned hospitals because they do a better job and are more affordable."

The provision in the legislation and efforts opposing these hospitals can be simply explained from Sandvig's view.

"It's anti-competitive. I think it's pretty clear," Sandvig said. "We're a model that makes sense that's affecting innovation. We're trying to do something better than it has been done. Anytime you do that, there's going to be a clash between the existing and the new. Unfortunately, it's a real David and Goliath battle.""

You asked for it, you got it.

[geocachingRN]

I live in an area with 3 hospitals; 1 doctor owned, 1 community, and 1 not-for-profit. From what I can find online, the community and not-for-profit each donate 3x in services to the community compared to the doctor owned. The doctor owned, doesn't have an ER and doesn't take high risk patients. Very nice place, yes, and legally they can't turn you away at the door if you were injured, but still. Not very community minded in comparison.

[SilentMind]

Less community oriented then other hospitals is still infinitely more community oriented then no hospital at all.

[SilentMind]

Did you also do a comparison to see what the net incomes were for all three hospitals?

[geocachingRN]

Did you also do a comparison to see what the net incomes were for all three hospitals?

That one is more difficult. The not-for-profit is part of a very large multi-state network. The community's P$L has them barely breaking even and the doc-owned has recently merged with another doc-owned string of clinics. I don't have the time to tease out this information.

[SilentMind]

So...honestly, your claim is faulty at best. That's like comparing the charitable donations of bill gates and an average working stiff.

[geocachingRN]

So...honestly, your claim is faulty at best. That's like comparing the charitable donations of bill gates and an average working stiff.

Hardly, I wouldn't compare a doctor-owned hospital to "an average working stiff."

My claim is based on information available on reputable internet sources (i.e. local non profit watchdog sites) of the amount of money spent on charitable services provided in my local county. Take it at that.

[SilentMind]

Your information is incomplete. You can say the other hospitals donate 3x more to the community. But that means absolutely nothing unless you can relate that to the resources each hospital has available.

[d'cm]

I think, without a doubt, that fundamentally this law is saying 'we don't want to continue down this road'. That road is one where increased access leads to increased utilization and with nothing to show for it except increased load on taxpayer. Unfortunately the bill as a whole fall far short of "reforming healthcare" as opposed to reforming healthcare insurance so an alternative to this approach to care is not evident in the bill. If doctors are really "trying to do something better than it has been done", let them build medical homes. This concept is supported by the bill in trial programs.

[elkpark]

Less community oriented then other hospitals is still infinitely more community oriented then no hospital at all.

Did you also do a comparison to see what the net incomes were for all three hospitals?

So...honestly, your claim is faulty at best. That's like comparing the charitable donations of bill gates and an average working stiff.

Your information is incomplete. You can say the other hospitals donate 3x more to the community. But that means absolutely nothing unless you can relate that to the resources each hospital has available.

So you post and accept unquestioningly a one-sided, self-serving article from a far-right website, and then tell everyone who posts another point of view their arguments aren't strong enough to suit you???

[tewdles, RN]

not surprising...

[NRSKarenRN, BSN, RN]

13 hospitals closed in PA in past 2 years. No new hospitals in my 5 county Philly in 30+ years. Many others merged. There are only 6 maternity units remaining in Philadelphia--prior had 15.

Within my health system in past 2 years: one out of 5 hospitals closed; other 4 closed maternity units; 3 SNF and 1 inpt rehabs closed.

All hospitals in my county closed their hospital based SNF/TCu units - total 5. Competing health system laid off 500 employees and closed 1 of 3 hospital based homecare agencies in 09......

all before Obama's health plan developed.

http://www.phc4.org/dept/dc/hospitalchanges.htm