It was bound to happen.
By “it,” I mean that the small group of speciality hospitals (usually orthopedic or cardiology-focused) across that country that are owned by doctors were going to have their “See! We Told ‘ya so!” moment.
Doctor-owned hospitals: How many are there? Two hundred and thirty-eight of them in the whole country (out of more than five thousand)–somewhere between four and five percent of the total in the U.S. (numbers courtesy TA Henry from this excellent piece).
What are the issues?
- ObamaCare effectively bans doctors from owning hospitals in the U.S.
- Those already in existence are grandfathered in under the law.
- We know that doctor-owned hospitals have higher average costs–hence the rationale for banning them under a law with the intent of “bending the cost curve.”
Cue the iron-o-meter:
In the most recent Medicare data (December 2012 report on “value-based purchasing“), doctor-owned hospitals did well in terms of achieving quality milestones.
How well?
Really well. Physician-owned hospitals took nine out of the top ten spots in the country. And in spite of their low relative number, forty-eight out of the top one hundred.
What’s the secret sauce? Here’s a little tidbit on the #1 ranked hospital from another excellent piece on this issue (J Rau of Kaiser Health News):
The top one is Treasure Valley Hospital in Boise, Idaho, a 10-bed hospital that boasts a low patient-to-nurse ratio and extra attention, right down to thank-you notes sent to each discharged patient.
A 10-bed hospital? Thank you notes for each discharged patient? Sign me up to go there next time I need hospital services.
Who cares? Well, we all should. Why?
It boils down to incentives.
When doctors own the hospitals, they stand to directly share in profits. If you’re a doctor-owner, and the hospital you both run and own is functioning at a high level, you think, “This is what America is all about. Free enterprise. Why shouldn’t I make more money if my hospital runs well?”
As a taxpayer, do I want government incentives going to hospitals that are privately owned and known for cherry-picking insured patients?
Moreover, what does it say about public hospitals, or academic centers, that often see the sickest, poorest, most vulnerable patients? Yes, their quality is measurably lower, according to this data. But now, in spite of staying true to their core missions (serving the public) they’re being further penalized.
Is this just another case of the rich simply getting richer?
Maybe ObamaCare’s got it wrong. Maybe we should build upon the model of doctor-ownership and turn over public hospitals to their workers. All of them. Let the nurses buy in. And the food handlers. And the “environmental services” folks (i.e. custodial crews). Let’s really let the workers own the means of production. Then we can see where incentives get us.
John H. Schumann, MD is a general internist and medical educator at the University of Oklahoma School of Community Medicine in Tulsa, OK . He is also author of the blog, GlassHospital (@GlassHospital), where this post originally appeared.
Categories: Uncategorized
All of them. Let the nurses buy in. And the food handlers. And the “environmental services” folks (i.e. custodial crews). how to do forex trading
Hi, i bbelieve that i noticed you viited my website so i came to return the favor?.I am trying to in finding things to enhance my website!I guess its adequate to use slme of your concepts!!
Acting professional and singer Patrick Bruel was among
France’s biggest stars during the ’90s, first making his name as being
a teen idol and leading a positive to traditional French chanson inside the new millennium.
Bruel was born Patrick Benguigui throughout Tlemcen, Algeria, on May 14, 1959.
His or her father abandoned your family when Patrick was just a year old, including 1962,
after Algeria acquired its independence, his mommy moved
to France, residing inside Paris suburb regarding Argenteuil.
A superb soccer player in his youth, Patrick first settled on the idea
of being artist after seeing Michel Sardou perform
in 1975.
As good luck might have it, acting would provide
him his first accomplishment; first-time home Alexandre Arcady ran an advert seeking a fresh man which has a French-Algerian (or “pied-noir”
in France slang) accent for his film Le Coup dom Sirocco.
Benguigui (as having been still called) responded and gained the part.
The next year, he spent a little while in New York City, where he attained Gérard Presgurvic, later
being his most important composer.
Source: http://www.curtrack.net/?p=1
Get a hold of a Forex Trading Signals service that offer their particular notifications direct towards trading
software. Numerous providers can right relate solely to the Metatrader trading
platform, the preferred forex trading platform readily available.
Just click regarding the free trial offer link.
La plupart des sites fraiches vont meme vous offrir une periode
d’essai de 30 jours alors que vous Vous trouverez dans cette page
la liste des sites que notre equipe editoriale a selectionnes.
Et chaque jours de nouveau streaming !
Here is my webpage: http://alturl.com/9B5ma
What’s up, of course this post is genuinely pleasant and I have learned lot of things from it regarding blogging.
thanks.
Very interesting, I never realized there are so few doctor owned hospitals. Definitely will have to see how this works in the long run.
Very interesting. Money talks loudly. Being owners of the hospital would likely speed up the turn-over times for my operating rooms.
Like.
hey Mary: check this out:
http://www.cms.gov/Medicare/Fraud-and-Abuse/PhysicianSelfReferral/Physician_Owned_Hospitals.html
Hey ARCpoint: glad you’re so interested…have you ever considered consolidating?
ObamaCare has been an interesting experience in the medical field. There has been so many changes made in the recent years.
I can see both sides to this argument. Only time will tell if ObamaCare was the right way to go.
Can you explain how doctor owned hospitals are banned under the PPACA? I think you are using “banned” in a contentious, inaccurate way.
Very interesting take on this. It will be interesting to see how this plays out in the long run. We should see soon enough if ObamaCare was a good move.