Study: MDs refer profitable patients to their ASCs

This isn't too surprising, but it's not something policymakers will like, either. A new study of referral patterns in the Philadelphia and Pittsburgh metros suggests that physicians who are high-admitters to physician-owned ASCs send far more privately insured patients to those facilities, while sending Medicaid enrollees to hospital outpatient departments, in many cases. The study, published in Health Affairs and completed through the University of Chicago, looks at whether having a stake in an ASC affects the types of patients a physician would refer to a facility. Research found that for the top 50 percent of physician referrals to ASCs, 45 percent of Medicaid patients were sent to hospital outpatient departments, while 92 percent of privately insured patients were sent to physician-owned ASCs.

Folks, these numbers seem to pretty much clinch the argument that ASCs keep the best-paying patients for themselves, while blocking the poor from getting whatever benefits the specialized ASC services might offer. Looks like this could kick off some heated discussions on Capitol Hill.

To get more information on the study:
- read the Health Affairs report
- read this Modern Healthcare article (reg. req.)

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