Surgical hospitals finally have good news
CMS doesn't plan to extend moratorium
In some long-awaited good news for surgical hospitals, the Centers for Medicare & Medicaid Services (CMS) has publicly announced that it doesn't plan to extend the moratorium. However, specialty hospitals that open in the future will face tighter scrutiny, according to testimony by CMS administrator Mark McClellan before a Senate Finance Committee.
That news leaves the American Surgical Hospital Association "cautiously optimistic," says Molly Gutierrez, executive director. "We are excited that we're turning a bit of a corner, hopefully."
That news also is reflected in a CMS' interim report on specialty hospitals. CMS is required to develop a strategic and implementation plan regarding whether physician investments in specialty hospitals are proportional to investment returns, whether the investment is a bona-fide investment, and whether CMS should require annual disclosure of investment information. The interim report found general hospitals made an average of 22 operational changes, such as quality evaluations, and eight clinical service changes, such as adding or expanding cardiology services, they would have made regardless of whether or not they competed with a specialty hospital.1
". . . There was little evidence to suggest that general hospitals made substantially more or fewer changes or different types of changes if some of their competitions came from a specialty hospital," according to the interim report.1
In its interim report, CMS reports on several actions undertaken during the past year, intended to diminish the incentives for the development of specialty hospitals, according to a release posted by the American Association of Ambulatory Surgery Centers.2 These actions include reform payment rates for surgery centers, reform payment rates for hospital inpatient services, and the disclosure that CMS will define a hospital on a case-by-case basis.
CMS is surveying specialty hospitals and general acute care hospitals seeking information about physician investment interests and provision of care to low-income patients. CMS is scheduled to submit a final report to Congress by Aug. 8.
References
- U.S. Government Accountability Office. General Hospitals: Operational and Clinical Changes Largely Unaffected by Presence of Competing Specialty Hospitals. GAO-06-520. Washington, DC; 2006. Accessed at www.gao.gov/htext/d06520.html.
- American Association of Ambulatory Surgery Centers. CMS Report Views ASCs and Payment Reform as a Solution to the Proliferation of Specialty Hospitals. Accessed at www.aaasc.org/advocacy/documents/CMSReport51206.doc.
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