Hospitals, practices partner for higher reimbursements

The purchase of physician practices by hospitals in Florida and North Carolina leads to more patients and profits, and drives up the cost of care, particularly high-priced treatments such as chemotherapy.

In Florida, Orlando Health Physician Group has doubled the number of its affiliated physicians from 200 to 400 thanks to practice acquisitions by hospital network Orlando Health, according to the Orlando Sentinel. As a result, prices are likely driving up.

"Doctors watch hospitals get higher payment rates, and they want in on that," Robert Berenson, an analyst at the Urban Institute's Health Policy Center, told the Sentinel.

This growing trend of hospital-practice mergers means higher reimbursement rates, as well as steeper out-of-pocket costs for patients, insurers claim, FierceHealthcare previously reported.

Network providers such as the Carolinas Health System are charging as much as 10 times the actual cost for chemotherapy drugs after purchasing independent oncology practices, the Charlotte Observer reported. Carolinas officials say the practice of cost-shifting is commonplace.

"The drug itself may just be the vehicle for charging for the services that are provided (elsewhere)," Joe Piemont, president of Carolinas HealthCare System, told the newspaper. "We make literally thousands of trades to have it balance," he said.

For more:
- read the Charlotte Observer article
- here's the Orlando Sentinel article

Suggested Articles

Humana filed suit Friday against more than a dozen generic drugmakers alleging the companies engaged in price fixing.

Medicare Advantage open enrollment kicked off last week, and insurers are taking new approaches to marketing a slate of supplemental benefit options. 

Health IT company Cerner announced a definitive agreement to acquire IT consulting and engineering firm AbleVets as a wholly owned subsidiary.