Some folks in Washington are really trying to do a number on physician-owned healthcare businesses. Trying to eliminate such facilities as competitors by cutting their Medicare payments or excluding them from the Medicare program is ultimately bad medicine for patients who rely on physician-owned ambulatory surgery centers or specialty hospitals for cost-effective and convenient care.
As Modern Physician reporter Andis Robeznieks outlines in this issues Top Story, President Bushs proposed fiscal 2009 federal budget includes a two-year freeze on Medicare payments to ASCs followed by limited pay hikes the next three years. All told, the price controls would reduce budgeted Medicare payments to ASCs by some $450 million over those five years. Congressional lawmakers have said Bushs proposal to reduce Medicare and Medicaid spending by $200 billion over five yearsof which the ASC cuts are a partis too extreme and will be scaled back if not dumped all together. Lets hope so.
Separately, opponents of physician-owned specialty hospitals led by the hospital lobby snuck a provision into the mental-health parity bill passed by the House last week that would all but put physician-owned specialty hospitals out of business by severely restricting their business operations (See this issues Recapping the News). The Senate version of the mental-health parity bill does not include the physician-ownership provision. When congressional negotiators attempt to reconcile the House and Senate bills, the hospital lobby will push to get the provision into the compromise legislation.
A ban on physician self-referral of Medicare patients to their own hospitals failed to make the final Medicare bill passed by Congress late last year that put off the planned 10% cut in Medicare payments to physicians until July 1 (Physician organizations face uncertainty in 2008, Jan. 7).
The physician lobby will need to stay alert on this one as the hospital lobby will attempt to attach it to any healthcare legislation winding its way through Congress this year. The mental-health parity bill in the House is just the first sneak attack.
As weve often argued in this space, introducing more competition into the healthcare marketplace is the best strategy to control costs, improve quality and expand access. Physician-owned ASCs and specialty hospitals provide a lot of that needed competition, and federal payment policies that threaten to put those facilities out of business ultimately hurt patients.