Delores Binion
MHA 620: Health Policy Analyses
Dr. Saran Tucker
ASHFORD UNIVERSITY
The Debate on Specialty and Community Hospitals
Since 2006, this debate has focused on specialty hospitals’ possible “unfair” competitive advantage. Little research has addressed whether specialty hospitals adversely affect the financial viability of general hospitals and their ability to care for low-income, uninsured and Medicaid patients. Despite initial challenges recruiting staff and maintaining service volumes and patient referrals, general hospitals were generally able to respond to the initial entry of specialty hospitals with few, if any, changes in the provision of care for financially vulnerable patients, according to a new study by the Center for Studying Health System Change (HSC) of three markets with established specialty hospitals in Indianapolis, Phoenix and Little Rock, Ark.
In addition, safety net hospitals (community hospitals) that care for a disproportionate share of financially vulnerable patients reported limited impact from specialty hospitals since safety net hospitals generally do not compete for insured patients. In my opinion, the only way to come to an objective conclusion is to treat all patients equally. I believe that the provision of services to the patient should not be based on provider financial incentives and that physicians should always prioritize the needs of patients when determining at which facility care is provided. It should be recommended that physicians should divulge to a patient any ownership interest in health care facilities, including specialty hospitals. The patient should be fully informed of his/her choices and be allowed to make the final determination as to where to receive care. Further, physicians with ownership interests in health care facilities should continue to adhere to the highest standards of quality and appropriateness of care without
References: Berenson, Robert A. Paulus, Ronald A., Kalman, Noah S., (2012) Medicare’s Readmission- Reduction Program-A Positive Alternative. New England Journal of Medicine 366:15 1364-1366. Medicare Payment Advisory Commission: A Path to Bundled Payment around a Hospitalization. Medicare Payment Policy. Report to Congress. June 2008. Policy for Inpatient Readmissions: Promoting Greater Efficiency in Medicare. Report to Congress. June 2007. Young, Jeffery. Grassley, Baucus chide CMS on specialty hospitals. May 17, 2006. Retrieved May 7, 2012, from http://thehill.com.