Several months ago, President Barack Obama identified eight principles detailing his philosophical stance on healthcare reform. As we continue to see new and more vigorous congressional action aimed at accomplishing some type of reform, I would like to take this opportunity to demonstrate how closely the business practices of physician-owned and -operated hospitals align with those eight principles.
- Guarantee choice: The plan should provide Americans a choice of health plans and physicians. People will be allowed to keep their own doctor and their employer-based health plan.
This guarantee is key to developing a uniquely American health system as choice is a core value of our society. Physician-owned hospitals offer patients and their physicians another alternative model for hospital care. Data collected by the CMS confirm the high level of patient satisfaction with their care at physician-owned hospitals.
Survey data substantiate that the public believes physicians should be in charge of hospitals and endorses physician ownership of hospitals. The number of physicians who admit patients to physician-owned hospitals dwarfs the number of physicians who actually have an investment interest in these facilities. For these factors and others, physician hospitals are an important element of the choice that the White House has advocated as a fundamental goal for health reform.
- Make health coverage affordable: The plan must reduce waste and fraud, high administrative costs, unnecessary tests and services, and other inefficiencies that drive up costs with no added health benefits.
Physician-owned hospitals are among the most cost-effective, efficient providers of care in the U.S. Physician ownership means that doctors are paying close attention to the bottom line for hospitals and especially for patients.
There is no room in this model for wasteful spending, excess administrative costs, unnecessary tests and services or any other inefficiency that would negate the core values embraced by physician owners. This is why our members can provide complex medical care at rates far below those charged by large general hospitals. This is why Medicare spends less for every patient who enters a physician-owned hospital than it does for the same care at large hospitals where interests are less aligned between doctors and administration. Physician ownership is the purest form of true physician/hospital alignment and is far more effective than the fabricated programs being considered such as gain-sharing and pay-for-performance.
- Protect families financial health: The plan must reduce the growing premiums and other costs American citizens and businesses pay for healthcare. People must be protected from bankruptcy because of catastrophic illness.
Our hospitals demonstrate every day that high-quality care can be affordable. The high quality of medical outcomes and financial efficiencies of physician-owned hospitals reduce pressure on the health insurance system and ease the burdens on patients and their families.
In fact, because of the affordability of care at our hospitals, several physician hospitals around the country currently contract to provide care to patients from countries such as Canada where healthcare access is limited. Because we are efficient, our hospitals can afford to provide such care on a feasible out-of-pocket budget.
In addition, we pay taxes and provide charity care. As the CMS found in its 2005 study, physician hospitals provide a net community benefit almost eight times higher than hospitals not owned and operated by physicians. Bottom line, physicians are in a position to know what is best for their patients and to make care-based decisions, not system policy-based decisions.
- Invest in prevention and wellness: The plan must invest in public-health measures proven to reduce cost drivers in our systemsuch as obesity, sedentary lifestyles and smokingas well as guarantee access to proven preventive treatments.
Every physician working at a physician-owned hospital is acutely aware of the need to encourage every citizen to embrace healthier lifestyles, regardless of age. The payback in improved health and enhanced quality of life is enormous and has value far beyond simply reducing spending for medical services.
At the same time, we must be prepared to address the acute illnesses and injuries that befall everyone at some point in their lives. Physician-owned hospitals are some of the most technologically advanced facilities in the country, bringing the best of modern medicine to their patients.
In addition, physicians are working to guarantee continued access in rural and inner-city areasareas that are otherwise being disregarded by many of the large system providers not owned by physicians.
In many states, physicians are purchasing and providing care at hospitals that are going bankrupt or otherwise being let go by previous nonphysician owners.
- Provide portability of coverage: People should not be locked into their jobs just to secure health coverage, and no American should be denied coverage because of pre-existing conditions.
Ours is a restless, mobile society and the failings of our health insurance system should never be an impediment to the ability of any individual to fulfill his or her own vision of their personal manifest destiny. Nor should any institution be allowed to corner the insurance market in a community to prevent market entry by new providers. Physician-owned hospitals have too often faced difficulty in negotiating insurance contracts because other hospitals have negotiated exclusive contracts.
Physician hospitals seek the right to provide care to everyone to whom appropriate care can be given, and to contract openly in an insurance market that provides portable, fair coverage.
- Aim for universality: The plan must put the U.S. on a clear path to cover all Americans.
This is a critical element of President Barack Obamas plan. The wealthiest nation in the world can no longer tolerate the fact that so many individuals who want to have health insurance are denied that opportunity. Physician Hospitals of America members try to do their part by providing charity care equal to 4.7% of their net revenue. We agree that insurance coverage for all would eliminate financial barriers to medical services, wherever they are provided; however, we also believe that such universality can be accomplished without encouraging, directly or indirectly, a single-payer system.
- Improve patient safety and quality care: The plan must ensure the implementation of proven patient-safety measures and provide incentives for changes in the delivery system to reduce unnecessary variability in patient care. It must support the widespread use of health information technology with rigorous privacy protections and the development of data on the effectiveness of medical interventions to improve the quality of care delivered.
Numerous public and private studies demonstrate the high quality of medical services provided by physician-owned hospitals. Physician owners strive to give their patients the best care possible and this is borne out by these statistics. PHA believes that the care models used by our member hospitals, such as low nurse-to-patient ratios that allow nurses to actually take care of their patients, should be emulated at all sites of service. We are happy to provide transparent information on the quality of care at physician hospitals and would be pleased to take part in any demonstration project aimed at improving quality and transparency for every hospital.
- Maintain long-term fiscal sustainability: The plan must pay for itself by reducing the level of cost growth, improving productivity and dedicating additional sources of revenue.
The productivity gains inherent in the physician-hospital model are impressive. If they could be replicated in other hospitals, the sustainability of our healthcare financing mechanisms would be greatly improved. Physician-owned hospitals have already shown that they can deliver the same care for less money than other hospitals. The Obama administration and Congress should demand that every hospital become as productive and efficient.
Molly SandvigExecutive directorPhysician Hospitals of America Submit a letter to the Modern Physician Reader Blog. Please include your name, title, company and hometown. Modern Physician reserves the right to edit all submissions.