Profits drive proliferation of trauma centers

Enticed by the promise of higher reimbursements and better outcomes, hospitals are increasingly adding trauma centers, opening up more than 200 since 2009 in more than 20 states, according to an article by Kaiser Health News and USA Today.

Trauma centers can improve outcomes: Patients treated at trauma centers have a 25 percent higher survival rate than those at hospitals without trauma services. Hospitals also can get higher reimbursements and fees for trauma services, the article noted.

But choosing the right market--and dealing with established competitors--can be tricky.

Nashville, Tenn.-based Hospital Corporation of America (HCA) has been an aggressor in the trauma market. But its competitors are challenging its plan to open up new trauma centers in Florida, according to the Associated Press.

Last year, Tampa General Hospital, Bayfront Medical Center and Shands Jacksonville Medical Center filed an appeal in state court to halt the opening of four HCA trauma centers in the area.

Shands, 18 miles away from HCA's propsed trauma center in Orange Park, Fla., has enjoyed being the region's sole trauma center since 1983. 

"We believe HCA is responding not to a market need, but instead is exploiting the system to increase their revenues," said Jim Burkhart, Shands CEO, according to the KHN article.

Although there might be enough room in a market for multiple trauma centers, market saturation can eat into profits and hurt quality, according to the KHN article.

For example, in highly concentrated areas, trauma centers have to compete for specialists. And fewer patients means a lower return on investment in technology and salaries, KHN noted. Further, when too many trauma centers operate in one region, clinicians treat fewer trauma patients, making it harder for them to improve their skills.

For more:
- read the KHN-USA Today article
- here's the AP article