Proposals to limit growth of specialty hospitals have come up at least three times before congressional negotiators of the Medicare bill, and the debate has been "contentious." But negotiators have delayed a decision so they can digest a newly released federal study on the topic, a lobbyist reports.
Randy Fenninger, Washington representative for the American Surgical Hospital Association, adds that negotiators' full-fledged debate on the topic may have begun as early as today.
He reports that as a relatively obscure part of the huge Medicare bill, specialty hospitals could become hostage to the biggest issue of all, drug coverage for Medicare recipients.
Negotiators have been talking about cutting acute care hospitals' payment update to help pay for the drug coverage, he says. But "if they take away something from the hospitals in that area, what do they give to make them feel better about it?" Fenninger says. "Well, we're on that list."
Fenninger says the negotiators, attempting to reconcile very different House and Senate versions of the bill, have put off deciding on specialty hospitals because they wanted to wait to read a General Accounting Office report released Wednesday.
But more importantly, "the topic has been very contentious and has led to no solution," he says.
The Senate version would bar exclusive physician investments in specialty hospitals. The specialty hospital group opposes that version, saying it would end the current building boom of specialty hospitals.
The House version, which Fenninger's specialty hospital group prefers, simply calls for a study to build on the GAO's reporting.
Meanwhile, Fenninger says Bill Thomas (R-Calif.), chairman of the House Ways and Means Committee, has proposed a compromise that would declare a moratorium on new specialty hospitals while the study is being prepared. Fenninger's group also opposes that proposal, saying a moratorium would harm specialty hospitals.
As the congressional negotiators gear up to debate on specialty hospitals, both sides are trying to put their own spin on the new GAO report.
Acute care hospitals are pointing to a key GAO finding that says there are concentrations of specialty hospitals in certain markets that could affect acute care hospitals in certain procedures.
In a release from Wednesday, the American Hospital Association says the report "further confirms that specialty hospitals are a drain on the general hospitals that provide vital patient services to all in their community."
In another Wednesday release, the Federation of American Hospitals says the report "provides clear, convincing data about the adverse effects of physician ownership of boutique specialty hospitals upon community hospitals and the patients they serve."
But Fenninger argues that state-by-state differences in treatment of specialty hospitals fund in the GAO report show that "states are already making the regulatory determinations that want to make, and the federal government should keep out of it."
Meanwhile, MedCath Corp. a leading specialty hospital company based in Charlotte, N.C., that concentrates on heart hospitals, issued a release Thursday trying to distance itself from other specialty hospitals.
"Facilities like MedCath's have much more in common with for-profit general hospitals than they do with specialty hospitals," the release states.
The release goes on to say that MedCath hospitals are licensed as general acute-care facilities, have emergency departments that treat a broad range of illnesses and "are viewed as an asset by each of the communities in which we operate."