See http://216.239.37.100/search?q=cache:f1VdipDpDrkJ:www.fahs.com/press_releases_and_testimony/01.30.02-Release.pdf+%22American+hospitals%22+%22History%22&hl=en&ie=UTF-8
GREAT HISTORY FOR for profit page
Nonprofit
to For-Profit Conversions by Hospitals and Health Plans:A Review
by Jack Needleman Assistant Professor of Economics and Health Policy,
Harvard School of Public Health
American Surgican Hospital Association Homepage
Profits
and Losses in Healthcare by Emily Friedman from Health Progress May-June
1966
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Volume growth (more people using more services) accounts for more than
half (55.4 percent) of the increase in spending on hospital services from
1997 to 2001, according to the report, ÇÄúCost of Caring: Key
Drivers of Growth and Spending on Hospital Care.ÇÄù Factors
accounting for volume growth include population growth and aging; the easing
of managed care restrictions; and new technology that allows more care
for more people.
Growth in the costs to hospitals in providing patient care accounts
for the remaining 44.6 percent of the growth in hospital spending, according
to the report. Most of the growth is attributable to labor costs due to
the national hospital workforce shortage. Other notable cost drivers include
rising expenses for drugs, medical devices, and liability insurance premiums.
said AHA Executive Vice President Rick Pollack. ÇÄúWe are faced
with a historic shortage of nurses and other caregivers, a crisis in professional
liability insurance and record-breaking costs of pharmaceuticals at the
same time weÇÄôre balancing
the need for investment in new technology, emergency preparedness and
patient safety initiatives.ÇÄù
The AHA is a not-for-profit association of health care provider organizations
that are committed to health improvement
in their communities. The AHA is the national advocate for its members,
which include nearly 5,000 hospitals, health care systems, networks and
other providers of care. Founded in 1898, AHA provides education for health
care leaders and is a source of information on health care issues and trends.
The Federation of American Hospitals (ÇÄúFAHÇÄù)
is the national representative of privately owned and managed community
hospitals and health systems throughout the United States. "RISING
DEMAND, INCREASING COSTS OF CARING FUEL HOSPITAL SPENDING
WASHINGTON,
DC (February 19, 2003)
"Until about 30 years ago Physician owned hospitals were fairly common. ...Typically, once they get these hospitals rolling, they cane can increase their income from 20% to 100%...because physicians are paid more for procedures performed at surgery".....Says one MD ' to gain control over how a hospital is run, you have to be an investor" The Quality Indicator. Physician Resource. Jan 2003.
"Blue Cross Health Insurance began being offered through employers in
the early 1930s. WW II
helped fuel research in medicine
that increased hospital demand and Kaiser advanced the first
Health Maintenance Program shortly
after the war ended. Up until 1966, hospitals remained
primarily volunteer organizations.
Then the Congress adopted Medicare and Medicaid for the
elderly. Today, 55 percent of
the payments to hospitals come from one of these two programs. With
the money now available, the private
sector became interested in opening hospitals and the growth
of physician-owned hospitals and
other for-profit hospitals continues today. Nationally 85 per cent of
hospitals are not-for-profit,
and in Orange County, 60 percent are not-for-profit/" http://pages.sbcglobal.net/tim-brown/wrkshp4.htm
"Recently USA Today examined the trend of physicians who become "hospital
entrepreneurs" by investing
in specialty centers that focus on services such as cardiac care and orthopedic
surgery. Proponents of the
controversial centers say they offer patients hotel-like amenities, give
doctors more control than do
traditional hospitals and create better medical care by focusing on specific
diseases or conditions. By
working in facilities that they own, doctors can increase their earnings
by seeing patients on a more efficient
schedule than that of traditional hospitals and by sharing the facility's
profits.
But opponents of the hospitals say they take lucrative services from traditional
hospitals, contribute to
rising medical costs by creating duplicative services, create conflicts
of interest for physicians and widen the
health care gulf between rich and poor. Frank Nachtman, chief executive
of Marshall Hospital, a traditional
facility in Placerville, Calif., said, "They'll skim off the cream, take
the profitable patients and dump the
unprofitable ones on us. They want the healthy and wealthy patients." He
added, "What about the sick and
the poor? This will cause the demise of the whole non-profit health care
system."
The trend has sparked a debate in Congress over how to regulate doctors
who refer patients to facilities
they own for treatment. House Ways and Means Committee Chair Rep. Bill
Thomas (R-Calif.) has
requested the General Accounting Office, the investigative arm of Congress,
to examine the impact of
specialty hospitals on health care costs, care for low-income patients
and traditional hospitals. Although
federal law prevents physicians from earning kickbacks on such referrals,
a loophole in the law permits
patient referrals to facilities in which a doctor has invested. Rep. Jerry
Kleczka (D-Wis.) has introduced
legislation (HR 2490) that would close that loophole."
March 2002
Physician-Owned
Hospitals Examined
The Healthcare Association of
Hawaii (HAH) is a non-profit
organization representing the
state's acute care hospitals and
two thirds of the long term care
beds with a total of 41 facilities.
"Hospitals
Examine Competitive Alternatives To Physician Owned Facilities
by Scott Becker and Kristian Werling, published in Chicago Hospital News
- March, 2003
Nationally and locally, over the past few years, there has been a proliferation
of physician owned hospitals and surgery
centers. Currently, there are approximately 3,500 surgery centers throughout
the country, the large majority of which have
some form of physician ownership. In addition to surgery centers, there
are an increasing number of hospitals that are also
owned by physicians."
"A Competitor Comparison [From Integrated Medical Delivery, with several surgical hospitals in three southeastern states]
IMD's distinctive approach to health care facility development is significantly
different from many other development
and management companies. IMD mandates physician ownership and control,
and supports physician
self-governance. IMD works for the physicians on a fee-for-service basis.
To illustrate our differences, please find our
Competitor Comparison below that details IMD's benefits.
IMD
Competitors
Equity Ownership
No more than 5%
10-60% depending on corporate structure
Management Fee
None
5-7% of collected revenues
Patient Account
Services
Provides all services at a percentage of
net collections or a flat fee
Facility has to provide all personnel and
systems to support patient account services
Facility Governance
Does not require voting member of
Executive Board
Executive Board my have non-physician
voting members
Management Agreement
30 day contract with declining early
termination fee - that reduces to zero after
24 months
Minimum 5 year contract with financial
penalties if terminated
Management Structure
Fee-for service customized to meet
Facility needs
Services defined by management
company, not by Facility
Technology Information
Systems "
Competitor Comparison