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Who pays the price when physician-owned hospitals offer lower cost care?

by Gus Iversen, Editor in Chief | July 04, 2023
Business Affairs

Renewed legislative interest
The Affordable Care Act prohibited physicians from opening new hospitals starting in 2010, but the new study comes at a time when Congress is reassessing that moratorium with H.R. 977, the Patient Access to Higher Quality Health Care Act of 2023.

Opponents of the bill, (including the AHA) argue it would allow physicians to self-refer the healthiest patients with the most profitable insurance arrangements to reap large profits for themselves, exacerbating care disparities by driving revenue away from other providers who will be left to deal with less profitable or unprofitable cases. Such an arrangement could put further strain on existing hospitals, leading to greater hardship for patients seeking treatment they cannot receive at non-physician-owned facilities.

Advocates for the bill, such as Physician-Led Healthcare for America, view its merits in terms of competition and an open market.

“Medicare allows the physician ownership of ambulatory surgery centers, imaging, physical therapy and in many other circumstances,” said Frederic Liss, president of the lobbying group, in an April statement. “Physician ownership is allowed because it leads to efficiency, high quality of care for patients and much needed competition that drives down cost. Our nation’s healthcare system has reached the point in which Americans are facing untenable costs, and it’s clear that it is time to remove the arbitrary ban on physician-led hospitals to spur competition.”

Additional reporting by John R. Fischer.

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