CMS star ratings renew call to lift restrictions on doc-owned hospitals

Although many industry groups continue to complain about the release of the CMS star ratings for hospital quality, one association is using the results to renew its call on the government to lift its ban on the expansion of physician-owned hospitals.

Doc-owned hospitals that remain in the Medicare program received high marks from the Centers for Medicare & Medicaid Services for quality--a remarkable achievement considering the organizations only comprise 5 percent of the total hospitals that the federal agency assessed, according to Physicians Hospitals of America, an organization that represents these facilities across the nation, in a statement emailed to FierceHealthcare

Thirty-seven of the 102 hospitals that received five stars were owned by physicians, PHA said. Of the 159 physician-owned hospitals assessed, 83, or more than half, received a four- or five-star rating. In comparison, the group noted that only 27 percent of non-physician-owned hospitals received four or five stars. 

PHA President Blake Curd, M.D., noted that these positive results highlight the need for the government to lift the ban on the expansion of these hospitals.

“Patients want high-quality care. They want to be able to choose where they receive care,” Curd said. “Patients are being turned away from these high-performing hospitals that are at capacity, forcing patients into lower-quality facilities where they suffer from infections and even worse outcomes.”

The Affordable Care Act restricts existing doc-owned hospitals from expanding and constructing any new physician-owned facilities that treat Medicare and Medicaid patients as part of a condition of participating in the Medicare program. The severe restrictions forced many facilities to drop Medicare.  

Attempts to loosen the restrictions have met with resistance from hospital lobbies. Many industry experts believe physician-owned hospitals draw the most profitable patients away from other hospitals, leaving those providers with sicker, lower-income patients. But recent research says the reputation isn't deserved and the facilities may be a better option for healthier patients