Physician-Owned Hospitals Should Be Included In ACA Repeal Bill

Picture a scenario in which you or your child needs surgery. If you could choose to have that surgery at a hospital that has a higher quality rating, greater level of patient satisfaction, and lower level of complications—all at a lower cost than the competition—would you want that choice? Would you want your surgeon to be an integral part of the hospital leadership team making decisions on what instruments and equipment are available, who works there, and even what food you may be served? Apparently, Congress does not think you should.

One of the little known provisions placed in the Affordable Care Act of 2010, more commonly referred to as Obamacare, was a ban on the growth and expansion of physician-owned hospitals. Since Obamacare’s passage, physician-owned hospitals have consistently ranked as some of the highest performers in care quality, as measured by the federal government’s quality programs. One of Obamacare’s great ironies is that the quality programs it created—Value Based Purchasing (VBP), Readmissions Reductions, Hospital-Acquired Condition Reduction—demonstrate that physician-owned hospitals deliver better care to patients.

Of the nation’s top 10 hospitals in the VBP program in FY 2017, seven were owned by physicians. And, 40 of the nation’s top 100 hospitals were owned by physicians, which is impressive considering the fact that only 5% of all hospitals in the nation are owned by physicians. Physician-owned hospitals comprised eight of the top 10 performing hospitals in Texas.

Physician-owned hospitals’ value is not limited to high clinical quality results. An analysis of CMS payment data by Avalon Health Economics demonstrated that physician-owned hospitals saved Medicare $3.2 billion over 10 years. In 2014 alone, this study found that physician-owned hospitals resulted in more than $258 million in Medicare savings.

As Congress considers a repeal of Obamacare, they should absolutely include a repeal of the ban on physician-owned hospitals. You and every patient deserve the freedom to go to the best, most affordable hospitals with the highest patient satisfaction and lowest complication rates. The very best hospitals should be allowed to thrive and grow, allowing even more patients to access their services.

Competition in any industry—especially healthcare—is a good thing, causing all facilities to up their game or risk fading away. It’s the American way. The high-quality, low-cost competition that physician-owned hospitals provide would be very beneficial to the entire healthcare system.

Of course, not all will agree. The other 95% of hospitals, championed by the large hospital industry lobby in Washington, do not like competition and were instrumental in getting the physician-owned hospital ban into Obamacare in the first place. They would prefer to see the restrictions stay in place, limiting your option to choose a better, safer facility.

What can you do? Tell your member of Congress and senators to include a repeal of the ban on physician-owned hospitals in any Obamacare repeal bill. Better yet, ask them where they would want to go if they or a member of their family needed surgery or hospital care. The best, of course.

John T. Gill, MD, has over 25 years of experience as a private practice orthopedic surgeon in Dallas. During that time he has been an active advocate on healthcare issues in both Austin and Washington, D.C. He is chairman of the Political Action Committee of the American Association of Orthopaedic Surgeons, serves in the House of Delegates of the American Medical Association, and is co chairman of the National Physicians Council for Healthcare Policy.

Posted in Expert Opinions.
  • bobby vassallo

    Good post by Tom Brosseau. Swearingen’s top hospital guy, in my thinking, should know. He’s been involved in several of these. At the end of the day, when does the federal government ever run a business better than the private sector?