Specialty Hospitals and Community Hospitals

Specialty Hospitals and Community Hospitals

Question 1

Answer.

There were some important developments regarding the debate since mid of 2006. On 30th May 2006, the senators received support by the American Hospital Association for their continuous support to the cause of fulfilling needs of the patients along with the community hospitals that provide medical care to them. The Senators had been standing up for the cause. A movement had been launched in support of the needs of the patients and the community hospitals. According to Berenson, the movement of the specialty hospital and the efforts in parallel by the physicians to control and regulate the service lines would result in the restoration of the relationship between the physicians and the hospital that preceded managed care.

An 18 month moratorium had been imposed by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, prohibiting payments to specialty hospitals that were either under the process of development or were not operational by November that year. The act was also applicable on hospitals in which physicians had ownership or some other investment interests. In August 2006, the CMS terminated the moratorium. CMS put forward the proposal to follow the MedPAC's (Medicare Payment Advisory Commission) recommendations. The recommendations were proposed with the aim to bring the DRG (diagnosis-related groups) payments closer to the costs of the hospital rather than the charges that are incurred by the hospitals (Iglehart, 2005).

Furthermore, another major development regarding the debate was that CMS's proposal to implement a rule that specialty hospitals would be binding to accept transfers of patients under the Emergency Medical Treatment and Labor Act. However, the decision had to face criticism as it was sharply questioned by ranking Senators Chuck Grassley (R-Iowa) and Max Baucus (D-Montana) at oversight hearings before the Senate Finance Committee. These members brought into notice the negative impacts of the decision on the community hospitals and other related conflicts that may arise (MNT, 2006).

Question 2

Answer.

If one tries to come to an objective solution, then he or she has to carefully consider a number of factors. The issue is not a very simple one, rather it is complicated. As seen in the discussion, a major aspect of the issue is to regulate the role of physicians as well as the community and the specialty hospitals. It has been found that physicians have been actively involved in actions that associate some sort of benefits including financial benefits. They have ownerships in hospitals that are mostly for-profit. Perhaps, out of the seventy-four percent for-profit hospitals in 2003, on an average were fifty percent owned by the physicians. Moreover, there has been a difference in the old and new specialty hospitals. The older ones tend to be non-profit, while the latter have been found to be profit oriented.

It is also found that the physicians engaged with for-profit hospitals have been engaged in activities such as having control on factors like staffing, scheduling, admission and discharge of ...