As Congress considers year-end legislative options, one small change in the Affordable Care Act could make a big difference in access to quality health care for millions of Americans: Lifting the ban on creation and expansion of physician-owned hospitals.
Physicians have an ownership stake in approximately 250 hospitals operating in 34 states, and they have a strong track record of providing quality care. Yet in 2010, the ACA slapped a ban on building new or expanding existing physician hospitals in response to cries from the megalithic general hospitals that claimed—erroneously it has now been proven—that private hospitals were “cherry picking” the most profitable patients.
Physician-owned hospitals (POHs) that violate the ACA bans are prohibited from participating in Medicare or Medicaid. More than 40 major expansion projects at existing hospitals were stopped in their tracks.
Hospitals owned by physicians are often the most efficient, state-of-the-art facilities in the country, the result of doctors’ desire to be involved in making detailed decisions about the staff, equipment, training, and procedures that can best serve their patients.
Seven of the top 10 hospitals receiving quality bonuses in the new Hospital Value-Based Purchasing Program in 2015 were physician-owned hospitals. This, despite the fact that POHs represent less than 5% of the 5,700 hospitals nationwide.
The Centers for Medicare and Medicaid Services released Star Ratings in 2015 based on consumer assessment surveys. More than 40% of physicians-owned hospitals received the top 5-star rating compared to only 5% of general hospitals.