Officials in Wyoming and Texas are the latest to tackle the hot-button issue of specialty hospitals; officials in both states are reviewing state-mandated reports with results that may favor the specialty hospital industry.
Since a federal moratorium on new physician-owned specialty hospitals ended in August, the debate has shifted to the states, where legislatures, healthcare commissions and hospital associations are still struggling to define these facilities and assess their impact on communities.
In Wyoming, researchers conducted interviews with stakeholders in Casper, Cheyenne, and the areas of Rock Springs and Gillette, and specialty hospitals in nearby states, to understand the effect of these hospitals on their general acute-care counterparts.
Currently there are no specialty hospitals in Wyoming, but that will change soon. Earlier this month, Chicago-based National Surgical Hospitals broke ground on a specialty hospital in Casper.
For Wyoming, for-profit status is what drives the creation of these hospitals, said Cheryl Fahlman, a health researcher at the Center for Studying Health System Change, Washington, and lead author of the Wyoming report. And there doesnt seem to be any long-term effect on general hospital operating margins, she said.
The report found that for-profit general hospitals had systematically higher operating margins than not-for-profit general hospitals and slightly lower amounts of uncompensated care.
The Wyoming commission will present policy recommendations to a joint committee of the state Legislature. These measures include improving hospital data collection statewide, as well as requiring all hospitals to pay into an uncompensated-care fund if they dont offer emergency care services or treat a comparable payer mix as other hospitals in the state.
The Texas report indicates that despite the states strong growth in specialty hospitals and a notable decline in general hospitals margins, there are no signs that specialty hospitals are to blame. A final report of the Texas study is due to the state Legislature by Dec. 1, the same day the Wyoming Healthcare Commission plans to submit its recommendations.
Greg Weiss, president and chief executive officer at Irving, Texas-based Mat-Rx Development, which partners with physicians to manage their hospitals, said advocates and opponents of specialty hospitals can use pieces of the report for their own purposes. My concern would be that the Legislature or (Texas Department of State Health Services) would use this report in a microcosm and not look at the industry as a whole.
Mathematica Policy Research, Washington, worked with HSC on producing the reports.