Physician-owned hospital industry opponents overstated previous research to their advantage, according to a new BMJ study which also found no evidence that POHs avoid poorer patients or patients from minority groups.
There are 219 physician-owned hospitals in the United States, often small and for-profit entities. There were 120 POHs that were general hospitals, and many are located in urban areas. The study compared POHs and non-POHs around patient populations, quality of care, cost and payments.
Here are five key findings:
1. Patients at POHs were younger on average — 77.4 years old versus 78.4 years old.
2. The POH patients were less likely admitted through an emergency room. Around 23 percent of the POH patients were admitted through the ER, compared with 29 percent of non-POHs.
3. There was an equal likeliness that the patients would be black — 5.1 percent for POHs and 5.5 percent for non-POHs.
4. The POHs reported 14.9 percent of patients used Medicaid, compared with 15.4 percent of non-POHs. The two groups also had similar numbers of chronic disease and predicted mortality scores.
5. Both POHs and non-POHs had similar patient experience scores, process of care, risk-adjusted 30-day mortality, 20-day readmission rates, costs and payments for acute myocardial infarction, congestive heart failure and pneumonia. The costs and payments were around $10,113 at POHs and $10,024 at non-POHs.
CMS payments for acute myocardial infarction, congested heart failure and pneumonia were around $7,217 at POHs and $7,033 at non-POHs.
6. Specialty POHs had higher patient experience scores than general POHs — 81.6 percent versus 57.3 percent. Specialty POHs also outperformed general POHs on an indirect composite measure of process for acute myocardial infarction, congestive heart failure and pneumonia.
7. Specialty POHs had a higher risk-adjusted readmission rate for acute myocardial infarction, congestive heart failure and pneumonia.
8. The study authors concluded POHs comprise just 6.3 percent of Medicare admissions in any given market. "It seems less likely that POHs are having a meaningful impact on the financial viability of non-POHs," they concluded.
"This study shows what we have been saying for years," said Blake Curd, MD, president of the Physician Hospitals of America. "When the study is combined with the latest CMS data on quality and patient satisfaction, our industry epitomizes the goals of sound healthcare delivery. Congress should correct the current policy that is bad for patients who have limited access to some of the best hospitals in the country."
The Affordable Care Act does not allow new POHs to accept Medicare and Medicaid patients and won't allow grandfathered POHs to expand if they want to continue serving Medicare and Medicaid patients.
"This policy is not consistent with the American ideal I am familiar with," said Dr. Curd. "It was put in the bill so the big hospital lobby would support the ACA."
The study authors urged a re-examination of existing public policies targeting physician-owned hospitals.