For any of my sick and elderly readers - besides Frosty, of course - check out this ditty on so-called "specialty hospitals."

Some physicians have been prone to "self-refer" patients to these places, where by total coincidence they have an ownership stake. Medicare studies released last week show these hospitals have above-average profits, are probably sucking away patients from the larger community hospitals, and have a below-average share of Medicaid patients.

They're also probably taking liberties with the Medicare patient schedule. Because of all the fuss, Congress put an 18 month moratorium on any further specialty hospitals, but that's expiring in June.

These places offer ridiculously good, specialized healthcare, however. Nobody wants to get rid of them, but certainly they need some regulating - plugging of Medicare loopholes before they move forward. The Democrats argue for an extension of the moratorium. The Republicans say, "Fuck that - we've got enough to go on. End of story."

(See? If only I could write this way all the time...)

I covered this on Thursday and sat next to Julie Rovner, which was dope. Of course, the PR pimps were all over Julie. Clearly, they did not appreciate the influence and power that is the Santa Barbara News-Press.

The editors extracted the local spin buried in the story and led with it. My administration fully supports this course of action. However, we cannot accept the following headline:

"Experts debate Medicare program -- Some say specialty hospitals exacerbate treatment, payment disparities."

My cabinet agrees that this language is convoluted, and makes it sound like specialty hospitals exacerbate treatment. We find this course of action unacceptable, and recommend the News-Press government withdraw this phrase immediately.

...

Anyways. If you'll excuse me, free booze and (hopefully) single ladies beckon from across the river. Oh yeah, and there's a wedding, too.

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Experts debate Medicare program | Some say specialty hospitals exacerbate treatment, payment disparities

5/14/05

LOCALLY

There are no specialty hospitals in Santa Barbara County, although there are at least six in California.

Santa Barbara Cottage and other community hospitals argue that physicians with ownership stakes in specialty hospitals tend to "cherry pick" patients who require less care, have better insurance, or both.

"It's the better-paying procedures and even the better-paying patients who often get taken away by these competitors," said Janet O'Neill, spokeswoman for Santa Barbara Cottage. "That is a real detriment to the not-for-profit community hospital like Cottage."


Ms. O'Neill added that she was not aware of any plans for a specialty hospital in Santa Barbara, and that Cottage Hospital works closely with its physicians to see "where the trends are going."


"We do recognize that physician income has been eroded threatened by shrinking reimbursement," Ms. O'Neill said. "We're in complete dialogue with our physicians."


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WASHINGTON -- Smaller, physician-owned hospitals, or "specialty hospitals," earned above-average profits while drawing patients away from larger community hospitals in recent years, top-ranking Medicare officials have reported.

Dr. Mark McClellan, head of the Centers for Medicare and Medicaid Services, told Congress that physician self-referrals to specialized facilities where the physicians have an ownership stake demonstrate imperfections in the current Medicare payment system. He said the referrals also reflect differences in the patients they served.

Glenn Hackbarth, chairman of the Medicare Payment Advisory Commission, added that physician-owned hospitals served proportionately fewer Medicaid patients than community hospitals.

He proposed reforming the Medicare system, adjusting payment rates to accurately reflect the severity of illness being treated.

Currently, more than 100 specialty hospitals serve as alternatives to the larger community hospitals for patients across the country.

But they're also mired in controversy. In 2003, Congress placed an 18-month hold on establishing new specialty hospitals so the government could study their impact on larger community hospitals. The hold expires next month.

Proponents maintain that physician-owned specialty hospitals provide competitive incentives that lead to improved quality.

"Specialty hospitals succeed because, as part owners, physicians not only treat patients but they also make sure facilities operate efficiently," said Karen Kerrigan, president and CEO of the Small Business and Entrepreneurship Council, in a statement to Congress. "Communities are welcoming specialty hospitals with open arms because of their exceptional patient care and economic development."


On Thursday, Mr. Hackbarth said that community hospitals facing competition tended to recover quickly after losing surgical patients to the specialty hospitals, by increasing revenues and reducing costs.

Additionally, he said that costs at specialty hospitals were higher despite significantly shorter stays.

None of the representatives at the hearing disputed that the Medicare payment system needed to be reformed. They disagreed along party lines, however, on the length of the moratorium needed to implement the proposed changes.

Mr. Hackbarth recommended extending the congressional moratorium through 2007, saying that would provide necessary time to implement the Medicare changes and gather more data.

On the other hand, Dr. McClellan proposed a shorter, self-imposed hold by Medicare on future specialty hospitals until the end of 2005. He said that would provide reasonable time for his agency to implement its recommended payment changes. "We want to get this right," he said.

House Democrats, including Santa Barbara Rep. Lois Capps, backed Mr. Hackbarth's longer extension plan. The Republican majority adamantly disagreed, favoring Dr. McClellan's idea. "We're not going to move a moratorium extension bill in this committee," Rep. Joe Barton, R-Tex., sternly told Mrs. Capps.

"If the practice of self-referral is bad, then the whole practice of medicine . . . in the modern era is bad," Mr. Barton said.


By DICKIE CRONKITE writes for Medill News Service from Washington, D.C. E-mail him at *******@newspress.com.