Bills in House and Senate that would lift ban on Physician Owned Hospitals

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Brahnold Bloodaxe

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Did you ever wonder how outrageous it is that mechanics can own and profit from garages, lawyers from law firms, and dentists from dental clinics?

Well, while we can't say for sure that former President Barack "Barry" Obama (PBUH) wondered about any of these things, he certainly did wonder about doctors owning hospitals, as evidenced by the fact he straight out outlawed them from doing so in 2010 as part of Obamacare. For this reason, many physicians find themselves in the unique position of being unable to own a stake in their own place of work, not by virtue of personal incompetence, laziness, or market forces, but through government fiat.

What is even more amusing is that Nurse Practitioners in states where such a title gives you unlimited scope of practice have no such restrictions. The federal government, in its infinite wisdom, has determined that "conflict of interest" only applies to people holding an MD after their name, while those with an NP are presumed to be immune to such temptations. So if you're an NP in an independent practice state, you can do all the same procedures and fill all the same roles as an MD, and you can own the hospital where you work as well while the MD can only ever slave away for "the man."

Anyway, now that I've had my fill of ranting, the point of this thread is to bring attention to a couple of bills that have been introduced in the house and senate recently that seek to allow us, as physicians, to own our own work rather than working to enlarge the bonuses of empty suits. Contact your representatives in support of these bills!

Senate Bill Would Lift Stark Ban on Physician-Owned Hospital Expansion | JD Supra

House bill would repeal limits on physician-owned hospitals

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I vaguely recall reading about this part of ObamaCare being put in because of big time lobbying from the AHA to quash the competition from physician-owned hospitals. Didn't this part of the bill just limit physician owned hospitals from billing medicare/medicaid?

If a physician owned hospital only billed insurance and cash then they were free to open up?

Either way, it is a good thing that the House and Senate are considering to lift this ridiculous law. Hopefully both chambers will pass it!
 
I vaguely recall reading about this part of ObamaCare being put in because of big time lobbying from the AHA to quash the competition from physician-owned hospitals. Didn't this part of the bill just limit physician owned hospitals from billing medicare/medicaid?

If a physician owned hospital only billed insurance and cash then they were free to open up?

Either way, it is a good thing that the House and Senate are considering to lift this ridiculous law. Hopefully both chambers will pass it!

Except now that most physicians are employed, good luck being able to compete with the existing corporations.
 
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We can own offices

Yes, we can. Unless "we" are physicians working in an inpatient setting such as radiologists, hospitalists, intensivists, almost all surgeons etc, in which case we can only work in hospitals, which we cannot own because Barry in his infinite wisdom did not approve of it.
 
I think it's fit to give this thread a celebratory bump in the wake of the 'rat defeat in the Georgia special election.:claps:

All the more appropriate in that the district in question was for a long time represented by Tom Price, the current HHS secretary and an orthopedic surgeon.
 
Yes, we can. Unless "we" are physicians working in an inpatient setting such as radiologists, hospitalists, intensivists, almost all surgeons etc, in which case we can only work in hospitals, which we cannot own because Barry in his infinite wisdom did not approve of it.
Umm, bull****. There are private radiology/pathology/hospitalist/pulm-cc groups all over the place. They can own free standing imaging/surgery centers. Sure, we can't own full on hospitals anymore but we can do pretty much anything else.
 
Umm, bull****. There are private radiology/pathology/hospitalist/pulm-cc groups all over the place. They can own free standing imaging/surgery centers. Sure, we can't own full on hospitals anymore but we can do pretty much anything else.

I agree with all of that, but I've never heard of privately owned/run hospitalist groups. How would that even work? Just doing the same thing as a hospitalist but contracting through a group?
 
I agree with all of that, but I've never heard of privately owned/run hospitalist groups. How would that even work? Just doing the same thing as a hospitalist but contracting through a group?
The group that covered my residency hospital admitted all medicine patients and billed separately from the hospital. That billing is what paid them, same as a private surgeon who admits at a hospital.
 
Umm, bull****. There are private radiology/pathology/hospitalist/pulm-cc groups all over the place. They can own free standing imaging/surgery centers. Sure, we can't own full on hospitals anymore but we can do pretty much anything else.

I think you are incorrectly equating "private practice" as contract/employment model with facility ownership. Yes, every physician, from a dermatologist to a transplant surgeon, can be a part of a private practice, but this has nothing to do with physician ownership of facilities, which is what this thread is about. Whether you're an employee of a hospital or part of a private group the hospital contracts with, you're still not getting any of the facility fee if you don't own a stake in the place, and we all know the facility fee is 90% of the money flow.

If you're a surgeon or a hospitalist or a radiologist you are basically restricted to working in a hospital setting by the nature of your work. Yes, there are freestanding surgery centers and imaging centers but the amount of "throughput" they account for is trivial compared to real hospitals because most operations have to be done in a full-fledged hospital.

Inpatient medicine is where the bulk of money in healthcare flows. To say physicians can't have an ownership stake of the inpatient money spigot and to brush it off with " we can do pretty much anything else" is a bit like saying you can't eat beef, chicken, or pork, but every other type of meat is fair game!

(As an addendum: because most of the money flows to hospitals, hospitals end up with all the financial firepower, which they are using to force physicians out of ownership of even the niches physicians are allowed to have stakes in.

So to summarize: government forbids physicians from owning hospitals, leading non-physicians to accumulate 90% of the money flow, which those non-physicians then use to force physicians from ownership in ASCs, clinics, infusion centers, etc.)
 
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I think you are incorrectly equating "private practice" as contract/employment model with facility ownership. Yes, every physician, from a dermatologist to a transplant surgeon, can be a part of a private practice, but this has nothing to do with physician ownership of facilities, which is what this thread is about. Whether you're an employee of a hospital or part of a private group the hospital contracts with, you're still not getting any of the facility fee if you don't own a stake in the place, and we all know the facility fee is 90% of the money flow.

If you're a surgeon or a hospitalist or a radiologist you are basically restricted to working in a hospital setting by the nature of your work. Yes, there are freestanding surgery centers and imaging centers but the amount of "throughput" they account for is trivial compared to real hospitals.

Inpatient medicine is where the bulk of money in healthcare flows. To say physicians can't have an ownership stake of the inpatient money spigot and to brush it off with " we can do pretty much anything else" is a bit like saying you can't eat beef, chicken, or pork, but every other type of meat is fair game!

(As an addendum: because most of the money flows to hospitals, hospitals end up with all the financial firepower, which they are using to force physicians out of ownership of even the niches physicians are allowed to have stakes in.

So to summarize: government forbids physicians from owning hospitals, leading non-physicians to accumulate 90% of the money flow, which those non-physicians then use to force physicians from ownership in ASCs, clinics, infusion centers, etc.)
I'm well aware of what we can and can't do. You were the one who talked about radiologists and pathologists not being able to own anything, and by default missing out on facility fees. You were and are wrong.

Literally the only thing we can't own are full-fledged hospitals.

You're also somewhat mistaken - if you look at the numbers most of the money in medicine is for elective procedures (whether they are MRIs, knee replacements, or spine surgery). Those are increasingly being done outside of the traditional hospital setting because of the money involved. As techniques improve and LOS goes down, that will even further shift these things to non-hospital owned settings.
 
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I'm well aware of what we can and can't do. You were the one who talked about radiologists and pathologists not being able to own anything, and by default missing out on facility fees. You were and are wrong.

Literally the only thing we can't own are full-fledged hospitals.

You're also somewhat mistaken - if you look at the numbers most of the money in medicine is for elective procedures (whether they are MRIs, knee replacements, or spine surgery). Those are increasingly being done outside of the traditional hospital setting because of the money involved. As techniques improve and LOS goes down, that will even further shift these things to non-hospital owned settings.

I certainly hope so...and I also hope this transition happens in time. If current trends of hospital systems buying up everything in sight continue, in a few years it won't matter what physicians are and aren't allowed to own by law. We'll transition from doing things in hospitals to doing things in outpatient facilities owned by hospitals.
 
The group that covered my residency hospital admitted all medicine patients and billed separately from the hospital. That billing is what paid them, same as a private surgeon who admits at a hospital.

So they were basically contracted by the hospital? Sounds almost like a long-term version of locums...
 
I certainly hope so...and I also hope this transition happens in time. If current trends of hospital systems buying up everything in sight continue, in a few years it won't matter what physicians are and aren't allowed to own by law. We'll transition from doing things in hospitals to doing things in outpatient facilities owned by hospitals.
Its already happening. There's an ortho/spine group in town that does outpatient knees and some spine work in their physician owned surgery center.

They just got permission to do 48 hour stays in said center to allow for more complex patients/procedures.
 
I've contacted my congressman more times in this past year than I ever have in my entire life, mostly for anesthesia-related reasons. I have 2 weeks off this summer before research starts. Someone else get this one, and wake me when it gets signed into law.
 
I think it's fit to give this thread a celebratory bump in the wake of the 'rat defeat in the Georgia special election.:claps:

All the more appropriate in that the district in question was for a long time represented by Tom Price, the current HHS secretary and an orthopedic surgeon.

Was never really in question, just CNN and other news sources trying to make it seem like the "resistance" was coming. Notice how you didn't see anything today on the news about Handel's victory


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Thank you so much for this post. I had actually just called my senator in support of the American Healthcare Bill before stumbling upon this. I'll be sure to let my rep know as well.
 
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