Antitrust case highlights tensions over MD-owned hospitals

An Overland Park, KS-based physician-owned specialty hospital is moving ahead with a federal antitrust suit against a group of area health systems, claiming that the systems conspired with managed care plans to drive the specialty hospital out of business. Heartland Spine & Specialty Hospital contends that among other things, area health systems jointly asked local managed care companies not to include it in their networks--and went so far as to give the managed care companies reimbursement cuts when they agreed.

Heartland Spine & Specialty Hospital named several large area providers as defendants in the suit, including HCA Midwest, St. Luke's Health System and North Kansas City Hospital. It's also targeted several insurers in its suit, including United Healthcare, Humana Health Plan, Cigna Health Care, Aetna and Coventry Health Care of Kansas. North Kansas City, Blue Cross and Blue Shield of Kansas City, Cigna, Humana and United have already settled with Heartland, but the case against the rest is going to trial in April.

I for one am eager to hear how this comes out. With the battle on between traditionally-structured hospitals and physician-owned hospitals across the U.S., the ruling could have much bigger implications than addressing Heartland's grievances.

To learn more about the case:
- read this piece from The Kansas City Star

Related Articles:
Questions arise over future of physician-owned hospitals. Report
Partnership building 10 doctor-owned hospitals. Report
Physician-owned hospitals: A conflict of interests? Report
Congress considers specialty hospital regulation. Report

Suggested Articles

The profit margins and management of Community Health Group raise questions about oversight of managed care insurers.

Financial experts are warning practices about the pitfalls of promoting medical credit cards to their patients.

A proposed rule issued by HHS on Tuesday would expand short-term coverage, a move Seema Verma said will have "virtually no impact" on ACA premiums.