Rather than learning from what doctor-owned hospitals do right, policy experts are doing their best to discount them.
Support responsible ownership of hospitals
Texas’ health care delivery system has changed dramatically over the past decades. Life-saving technologies and treatments, and the types of settings in which patients receive services have proliferated. Physicians, hospitals, and others have invested extensively in these technologies and settings. While physician investment in the health care system is not new, there have been considerable changes in health care coverage, financing, licensing, and regulatory environment over the past decade. These changes drive the debate over who should invest in facilities. Texas is also the uninsured capital of America, which creates competition for a dwindling supply of paying patients.
TMA strongly supports responsible physician investment in technology, facilities, services, or equipment. Physicians invest in facilities to improve the effectiveness, efficiency, timeliness, and quality of the care they provide to their patients. The focus should be not on who owns the medical facility — a physician, a nonprofit entity, or a for-profit company — but on the quality of the facility and appropriateness of patient care. Referrals to a physician-owned entity or an entity in which the physician has a financial relationship must be based on the patient’s medical needs, and full disclosure of financial relationships to patients is appropriate. If overutilization or deviations from quality care are the issues, legislators should address those problems regardless of ownership, rather than limiting patient choice and innovation in the marketplace.
One of the more egregious sections of the Patient Protection and Accountable Care Act significantly inhibits physicians’ legal right to own or invest in hospitals and other facilities that provide high-quality care to their patients. Section 6001 prohibits new doctor investment in hospitals that take Medicare patients; no physician-owned hospitals may start nor may current ones expand.
Federal law should not interfere with physician ownership of hospitals. Studies show physician hospitals have better health care outcomes, shorter hospital stays, and much higher patient satisfaction ratings than nonphysician-owned hospitals. In Texas, physician-owned hospitals employed 22,226 people and paid $1.2 billion in salaries in 2009.Nationally, physician-owned hospitals provide, on average, approximately 6.2-percent charity care. These hospitals pay billions in salaries, hundreds of millions in taxes, provide charity care, and deliver services in underserved or abandoned areas. TMA has filed several legal briefs that support a lawsuit seeking to overturn Section 6001 of the PPACA.