Pa. hospitals say ambulatory centers undercut finances

Across the country, battles continue to play out between hospitals and ambulatory surgical centers. Hospitals say the playing field just isn't level--that ASCs are skimming off profitable commercially-insured customers. This is particularly unfair given that the ASCs don't have to offer indigent care, execs say.

That fight has been thrown into particularly sharp relief in Pennsylvania, where the state keeps close tabs on the ambulatory surgery business.

The latest action in this skirmish came last week, when the Pennsylvania Health Care Cost Containment Council (PHC4) released a report outlining the ongoing success of ASCs there. Almost immediately, the Hospital and Healthsystem Association of Pennsylvania hustled out its own position on the results.

According to the PHC4, ASCs did very well during some of the worst months of the financial crash. The centers actually grew their total margins from 24.31 percent in fiscal '07 to 26.06 percent in fiscal '08, a 15 percent increase in total margin since fiscal 2001.

Meanwhile, acute care hospitals averaged 0.38 percent statewide for fiscal year ending June 30, 2009, HAP says. "This report should draw the attention of regulators and legislators as they examine the extent to which ambulatory surgery centers--which now far outnumber general acute care hospitals--are impacting increases in health care costs," said HAP President and CEO Carolyn F. Scanlan in a news release.

I think HAP might get further with their argument if they could draw a straight line between hospitals' low margins and competition from the ASCs. (In reality, the poor economy and still-struggling investment returns probably played a much bigger role in their overall health last year.) Still, this issue is likely to get more attention once the initial reform excitement dies down.

Get the word straight from HAP:
- read this HAP press release

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