The American Medical Association is countering efforts calling for the increased regulation of specialty hospitals owned by physicians.
Earlier this month, the hospital industry brought a unified front to lobby against hospitals owned by physicians. These ventures typically treat a narrow range of conditions, often focused on one specialty, and don't provide the wide range of services at larger community hospitals.
In particular, the American Hospital Association touted a recent report citing the negative effects of physician ownership and self-referral, when physicians own the facilities to which they refer patients.
In defending the facilities, an American Medical Association letter painted the AHA efforts as "nothing more than a power grab by the hospital industry."
Provisions to ban specialty hospitals had been included in a farm bill that Congress had been padding with a variety of provisions covering a wide range of legislative initiatives. Wording in the bill that would have affected specialty hospitals was pulled after an outcry from House lawmakers and the AMA.
"The hospital industry's campaign to eliminate physician-owned hospitals has nothing to do with patients and everything to do with eliminating competition," said William G. Plested III, MD, immediate past president of the AMA.
The Department of Health and Human Services also has weighed in with a study critical of specialty hospitals, primarily for the inability of about half to provide emergency care services.
The AMA charged that the AHA and two other hospital organizations misused information in the HHS report, saying the hospital groups received a letter of rebuke last month from the Department of Health and Human Services for including statements that misrepresented the report, conducted by the Office of the Inspector General for HHS.
"Studies show that the quality of care patients receive at specialty hospitals is high, and the patients like the choice of care, so there's simply no good reason to try and get rid of them," Plested added.
Specialty hospitals have been criticized for the narrow range of care and questions over their ability to handle emergency cases. Concern has grown after two high-profile cases in which patients died after complications arose and specialty hospital staff had to call "9-1-1" to request emergency transfers of patients to full-service community hospitals.
The AHA report said that 96 percent of physician-owned hospitals opened between 1990 and 2003 did so in states without certificate of need laws, which provide governmental review for whether planned medical construction is necessary. The AHA report also correlated physician self-referral with higher utilization and costs.
The AHA report also cites evidence that physician-owned hospitals have higher-than-average costs and contends that they are not efficient, and it questions their quality of care and availability of care to all populations.
"Research shows that physician ownership results in financial incentives for physicians to steer more complex and costly patients to community hospitals while referring less complex, well-insured patients to their own facilities," the AHA report concludes. "These selective practices compromise community hospitals' ability to offer essential services such as emergency and trauma services and uncompensated care."
The AMA refutes those findings, saying that multiple studies have found high levels of quality care and patient satisfaction. It says government studies have found fewer complications, like infections and hip fractures, at specialty cardiac hospitals, and that specialty hospitals provide more net community benefits, through uncompensated care and taxes, than not-for-profit competitors as a share of total revenues.
"The physicians of America are committed to providing patients with high quality care, and improving the health care system through innovations like specialty hospitals," Plested said. "We urge Congress to reject the power grab by the hospital industry and continue to allow high-quality facilities...to continue to care for patients."