Do Physician-Owned Cardiac Hospitals Increase Utilization?

Stensland, Jeffrey; Winter, Ariel

doi:10.1377/hlthaff.25.1.119

Cited by 30 publications

(14 citation statements)

References 15 publications

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“…2005; Greenwald et al 2006;Stensland and Winter 2006;Cram, Rosenthal, and Vaughan-Sarrazin 2005). Little research has examined whether the financial incentives linked to hospital ownership affect utilization of surgical procedures.…”

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confidence: 99%

“…Little research has examined whether the financial incentives linked to hospital ownership affect utilization of surgical procedures. Researchers at MedPAC analyzed changes in market area utilization for cardiac surgeries performed on Medicare patients over the time period 1996 through 2002 for markets with and without physician-owned heart hospitals (MedPAC 2005;Stensland and Winter 2006). These analyses were updated by adding data for 2003to 2004(MedPAC 2006.…”

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confidence: 99%

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Utilization Changes Following Market Entry by Physician-owned Specialty Hospitals

Mitchell

2007

Med Care Res Rev

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Physician ownership of specialty hospitals has become commonplace in recent years in several states where certificate-of-need laws do not exist. The study examines trends in utilization rates for complex and simple spinal fusion procedures performed on injured workers with back/spine disorders in two markets in Oklahoma. During the time period we examine, physician-owned spine or orthopedic specialty hospitals entered both market areas in Oklahoma. Because there were no market areas in Oklahoma without physician-owned spine or orthopedic hospitals to use as a comparison group, we also analyzed trends in utilization for these surgical procedures performed on Medicare beneficiaries. We compared utilization for these procedures in Oklahoma and three other states with a high concentration of physician-owned specialty hospitals (Kansas, South Dakota, and Arizona) to utilization rates for back surgery performed on Medicare patients who reside in the Northeast region. States in the Northeast constitute an appropriate control group because there are no physician-owned specialty hospitals in this region. Both analyses indicate that the entry of the physician-owned specialty hospitals was followed by substantial increases in the market area utilization rates for complex spinal fusion surgery. Conversely, such dramatic changes did not occur in the Northeast where physician-owned specialty hospitals do not exist. After considering but ruling out alternative explanations, the findings imply that the financial incentives linked to ownership coincided with significant changes in physicians' practice patterns.

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confidence: 99%

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Utilization Changes Following Market Entry by Physician-owned Specialty Hospitals

Mitchell

2007

Med Care Res Rev

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“…Recent studies of regional variations in Medicare spending found that areas with higher reimbursement have increased physician supply as compared with other areas. 23,24 Higher physician-to-population ratios were associated with increased usage of some services. 25 There tend to be correlations between economic growth and health care utilization over time and among large geopolitical units at single points in time.…”

Section: Competitionmentioning

confidence: 99%

In a Niche of Time

Poole

Davis

Gunby³

2013

The Health Care Manager

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Niche hospitals represent a growing segment in the health care industry. Niche facilities are primarily engaged in the treatment of cardiac or orthopedic conditions. The effectiveness of this strategy is of interest because niche hospitals focus on only the most profitable services. The purpose of this research was to assess the financial effectiveness of the niche strategy. We theorize that firm and market-level factors concomitantly with the strategy of the hospital-niche versus traditional-are associated with financial performance. This research used 2 data sources, the 2003 Medicare Cost Report and the 2003 Area Resource File. The sample was limited to only for-profit, urban, nongovernmental hospitals (n = 995). The data were analyzed using hierarchical least squares regression. Financial performance was operationalized using the hospital's return on assets. The principal finding of this project is that niche hospitals had significantly higher performance than traditional facilities. From the organizational perspective, the niche strategy leads to better financial performance. From a societal perspective, the niche strategy provides increased focus and efficiencies through repetition. Despite the limited focus of this strategy, patients who can access these providers may experience better outcomes than patients in more traditional hospitals.

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“…For example, with the emergence of physician-owned hospitals that specialize in cardiac, surgical, or orthopedic services, questions arose over whether such facilities were associated with greater and unnecessary use of services. 4 The issue generated intense debate between full-service hospitals and the physician-owners of these specialty facilities. The hospitals accused the specialty facilities of "skimming the cream," or targeting less-ill patients needing services that were comparatively well reimbursed by public or private insurance.…”

Section: Overpayments Utilization Targetedmentioning

confidence: 99%

The Supercharged Federal Effort To Crack Down On Fraud And Abuse

Iglehart¹

2010

Health Affairs

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Do Physician-Owned Cardiac Hospitals Increase Utilization?

Cited by 30 publications

References 15 publications

Utilization Changes Following Market Entry by Physician-owned Specialty Hospitals

Utilization Changes Following Market Entry by Physician-owned Specialty Hospitals

In a Niche of Time

The Supercharged Federal Effort To Crack Down On Fraud And Abuse

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