A bipartisan bill has been introduced in the House of Representatives would amend aspects of the Affordable Care Act passed to ease the ban on physician-owned hospitals.
Here are 10 things to know:
1. Michael Burgess, MD, (R-Texas), Tony Cardenas (D-Calif.), Morgan Griffith (R-Va.), and Vincent Gonzalez (D-Texas) introduced The Physician Led and Rural Access to Quality Care Act on July 11.
2. The bill would allow physicians to open a hospital in a rural area where there isn't another hospital for 35 miles, or 15 miles in a mountainous area, according to a news release posted on Dr. Burgess's website.
3. The bill would also allow existing POHs to grow and expand services.
4. "Having owned my own practice, I understand the critical importance of affordable healthcare prices and timely access to high-quality care," Dr. Burgess said in the release. "I am honored to lead this bipartisan legislation with my fellow members to ensure that rural patients across America receive the care they need."
5. The American Medical Association, the American Association of Orthopaedic Surgeons and Physician-Led Healthcare for America have voiced support for the legislation.
6. "With consolidation on the rise in all areas of healthcare leading to higher costs, it's crucial that Congress pursue policy solutions to increase competition, especially among hospitals," Bruce Scott, MD, president of the American Medical Association, said in a release. "...This balanced approach will undoubtedly usher in high quality healthcare across the country, especially in rural areas."
7. Physician-owned hospitals saved $1.1 billion in 2019 compared to traditional facilities, according to a report analyzing the cost of 20 of the most expensive conditions for Medicare patients. Payments for some of the most expensive diagnostic groups were 8% to 15% lower in POHs than traditional facilities.
8. Hospital groups have been pushing back against efforts to eliminate the ban on physician self-referral to new POHs, alleging that they choose patients with better coverage and leave the burden of high-cost care to other hospitals and the government. In an October blog post, American Hospital Association Executive Vice President Stacey Hughes and Federation of American Hospitals President and CEO Chip Kahn outlined their argument in five points.
9. Physician-owned hospitals have worse readmission and Medicare quality measures than community hospitals, according to an analysis from the American Hospital Association. The analysis found that POHs have lower Medicaid discharges as percent of total discharges, lower percent of Medicare inpatient claims with emergency room services, lower percent of Medicare inpatient claims for patients with dual eligibility and lower percent of Medicare inpatient claims for patients 85 or older.
10. "Healthcare consolidation and the hospital closures that have resulted have left millions in rural areas without access to needed care,” Michael Darrouzet, vice president of Physicians Advocacy Institute and CEO of the Texas Medical Association, said in a statement. "The expansion of physician-owned hospitals is a crucial step towards restoring access to healthcare for everyone in the United States, regardless of their ZIP Code."