Healthcare reform legislation being proposed by the House Ways and Means health subcommittee could limit where and how physician groups practice, healthcare executives were warned last week.
Donald W. Fisher, executive vice president and chief executive officer of the American Group Practice Association, told attendees at the Integrated Healthcare Symposium in Aspen, Colo., that current legislative initiatives under consideration would require medical services "be furnished personally by a physician in the same group practice or personally by individuals who are directly supervised by a physician in the group practice."
The proposed legislation, which expands the scope of the ban on physician self-referrals, concerns the AGPA and its physician-driven health systems because the legislation restricts services offered at multiple "satellite sites," away from main campus healthcare facilities (See related story, p. 50).
Under the proposed legislation, sponsored by Rep. Fortney "Pete" Stark (D-Calif.), medical groups and integrated systems would be blocked from providing services outside of main healthcare facilities.
Mr. Fisher said the proposal would "destroy the ability of physician groups and integrated healthcare systems to provide care regionally or to operate multiple sites."
He added: "The critical concern for each group practice and integrated healthcare system is the extent to which their menu of services provided by satellite offices within a metropolitan statistical area is affected by these proposed provisions."
Some 500 executives of healthcare systems and physician group practices attended the symposium.
The AGPA, a trade organization composed of some of the nation's most prestigious medical clinics, also has been lobbying Congress on various other proposed healthcare reform initiatives, including states' flexibility to adopt reforms and the formation of healthcare purchasing alliances at the state level.
Mr. Fisher said AGPA is involved in helping to shape policy regarding states' participation because Congress and the Clinton administration have demonstrated a willingness to give states autonomy to reform and organize their own healthcare systems. "This will potentially change the way healthcare systems book business," he added.
Because the creation of healthcare alliances could lead to the formation of some 50 state-operated purchasing plans, Mr. Fisher warned healthcare executives of the need to prepare their organizations to seek out and negotiate with those different governing bodies managing the alliances.