Idaho Flaneuse raised a good point in yesterday’s post regarding models of medical care and the economics of referral.
I wonder how this will work with the consolidation of doctor’s practices. Here in Boise most of the primary care practices have been bought by the hospitals here. I don’t have personal experience, but I think that some of the specialist practices have also been purchased by the hospitals. Seems likely to me that the doctor will send you to the hospital that owns them rather than the one that is rated the best. Will this leave the patient fighting to go to the better rated hospital or bearing a larger burden of cost if they don’t?
This is one of the big problems with system and delivery reform. The business model requires a lot more regional coordination without ownership barriers.
Hospitals buy up provider practices for a few reasons. Before last year’s budget bill, one of the big reasons was to transform outpatient centers into off-campus hospital facilities that could charge a much higher Medicare rate. That revenue hack is gone for new acquisitions. The other two reasons are prestige of the hospital now being able to offer a high profile program and referral patterns.
Filling the bucket in vertically integrated medical practicesPost + Comments (10)