Health News Review

As the Affordable Care Act – the health reform bill – is shaped and defined, all sorts of “carve out your turf” battles are being waged on many levels not only in Washington, but in individual states.

One caught our eye this morning:  A Denver Post story, “Suit sets up clash between day-surgery centers and hospitals, insurers.” Excerpts:

Four Colorado day-surgery centers have filed a lawsuit alleging a conspiracy by the state’s largest hospital chains and insurers to drive them out of business, while the defendants allege the surgery centers may violate insurance and kickback laws, bringing a battle of health titans into the open.

The suit also claims the hospitals, which operate lucrative day-surgery centers of their own, threatened their own doctors for referring patients to the outside surgeries. It says hospitals refused to accept patients treated at the outside surgery centers who had complications and needed inpatient care, a customary pact within the health industry.

Appropriately, the Denver paper paints a broader picture than just the local scenario:

The Colorado filing and lawsuits in California detail an acrimonious and expensive battlefield littered with billion-dollar combatants.

The insurance companies are the aggressors in California lawsuits claiming doctor-owned surgery centers there have cost them tens of millions in overpayments.

Consumers are well served by journalism that digs into these turf wars.  This was a 1,000-word story – run-of-the-mill in a recent but bygone era but rarer in many of the nation’s local newspapers today.


Greg Pawelski posted on November 24, 2012 at 8:42 am

One of these local health care turf wars happen here. The surgeons involved with the Surgical Institute of Reading put together this facility because the “Elephant” in county (Reading Hospital) was just too damn big! Operation scheduling and infections were a big, big problem. The doctors had no control over it. So they took control and opened their own facility. It did provide meaningful competition that I presumed held down prices.

And now Reading Hospital wanted to buy out the Surgical Institute!? I don’t think holding down prices was the projected plan. I believe our State Attorney General was right, the merger would have reduced competition and brought higher prices for many kinds of medical services. After the FTC announced plans to challenge the hospital’s acquisition of the physician-owned hospital, the deal was called off. It would have substantially reduced competition and lead to reduced quality and higher healthcare costs.