Amid concerns that specialty facilities cherry-pick the most profitable patients comes news that Southern Nevada's smaller specialty hospitals financially outperformed its general hospitals last year, reported the Las Vegas Review-Journal.
According to Nevada Department of Health & Human Services data, the 14 specialty facilities reported an operating profit of $54.7 million in 2011, while general hospitals posted a $28.8 million loss.
The specialty hospitals attribute the disparity to operational functions; general hospitals serve of a wide variety of conditions while specialty hospitals are targeted to a specific service line. "The biggest single difference is overhead. We have no emergency room, no trauma center, no MRIs," Horizon Specialty Hospital CEO David Tupper told the Review-Journal.
Although specialty hospitals can accept any insurance and charity care patients, all admissions occur through physician referral, allowing them to select patients based on health insurance, the article noted.
Highlighting issues with physician referrals to specialty hospitals, the New Hampshire House of Representative passed a bill that will allow for-profit specialty hospitals to bypass the certificate-of-need process and exempts them from paying the state's Medicaid, reported New Hampshire Public Radio.
Noting an unfair advantage, Rep. Rich DiPentima (D) said, "They cherry pick the best patients with the best insurance and take those away from our existing community hospitals ... leaving our community hospitals with a greater burden, a greater percentage of their patients relying on Medicaid and uncompensated care."