This website uses cookies to ensure you have the best experience. Learn more

Specialty Hospitals And Community Hospitals Essay

2171 words - 9 pages

Specialty Hospitals and Community Hospitals
The Medicare Prescription Drug, Improvement, and Moderation Act of 2003 enacted an 18-month moratorium to investigate whether specialty hospitals privately owned by physicians were unjustly profiting from self-referrals to their own hospital (McLauglin & McLauglin, 2008). Many critics of these specialty hospitals contend that they draw the most profitable patients to their facilities; therefore making it more difficult for community hospitals to generate funding for their less-profitable services such as the emergency room (Tynan, November, Lauer, Pham, and Cram, 2009). However, the defenders of specialty hospitals claim they provide better quality services and receive higher patient satisfaction ratings than community hospitals (Tyanan et al., 2009). This case study discusses new reforms for specialty physician-owned hospitals since the Medicare Payment Advisory Commission (MedPAC) moratorium was lifted in 2006, the implications of these reforms for both specialty physician-owned and community hospitals, why possible specialty physician-owned hospitals were opened during the 18-month moratorium period, and changes to Medicare diagnosis-related groups (DRGs) used for reimbursement.
Reforms for Physician-Owned Specialty Hospitals
There have been a few significant changes since 2006 that affect how physician owned specialty hospitals run their private businesses. In August 2006, the moratorium for specialty hospitals was ended with MedPAC proposing new reforms affecting private for profit specialty hospitals (McLauglin & McLauglin, 2008). The proposals stated that the Medicare DRG reimbursement hospital payments should be revised so they more closely matched actual costs and specialty hospitals start accepting more patients under the Emergency Medical Treatment and Labor Act (McLauglin & McLauglin, 2008). In 2007, the Centers for Medicare and Medicaid Services (CMS) did finalize reforms to the DRG hospital reimbursement system that were implemented in 2008 (CMS, 2007). CMS (2007) reported they would begin the inpatient prospective payment system (IPPS) ensuring Medicare inpatient hospital payments more accurately reflected the patients’ actual medical conditions by restructuring the DRGs. They also put measures in place to make sure Medicare was not providing extra payments for hospital-acquired conditions that patients developed during their hospitalizations. They state the old 538 DRGs were revised and replaced with 745 new DRGs that are more predictable, reliable, and fair. In addition, they emphasize hospitals that take care of more critically ill patients will receive more reimbursement compared to those that only treat healthier patients. Finally, they reveal regulations will be put in place stating physician-owned specialty hospitals will have to notify their patients if a doctor of medicine or osteopathy is not available at all times in the hospital and provide CMS a plan of how...

Find Another Essay On Specialty Hospitals and Community Hospitals

On The Construction, Organization And General Arrangements Of Hospitals For The Insane (1854)

1186 words - 5 pages insane which is commonly known as "The Kirkbride Plan." He wrote many articles and reviews for medical journals and also published three books. His third book, On the Construction, Organization, and General Arrangements of Hospitals for the Insane (1854), was a very technical and thorough collection of his theories on the topic. Dr. Thomas Kirkbride's theories on the architecture, activities, and medical treatment for the mentally ill were the

Case Study: U.S. Hospitals and the Civil Rights Act of 1964 - Ethics/Civil Rights - Case Study

751 words - 4 pages assistance” this provision includes hospitals, especially hospitals that are not intergraded. This changed healthcare forever, especially when Medicare was born. Medicare is a federally funded program which means a hospital that accepts Medicare must meet all the rules and regulations of Title VI of the Civil Right Act. This forced hospitals to desegregate because if they did not meet the rules and regulations of Title VI and provided admission to

Quality care of patients in hospitals and the current nursing shortages

1215 words - 5 pages Ways to assess the care of loved onesAccording to the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the growing shortage of nurses in America's hospitals is putting patient lives in danger and requires immediate attention. "The current nursing shortage threatens to heavily impact our citizens' health and our nations' security preparedness". (Person, 2003) The nursing shortage that is sweeping across the United States has

Building of the six psychiatric hospitals in Northern Ireland was completed by 1898. How and why has mental health policy in NI developed since then?

2640 words - 11 pages a Key question of, have the mentally ill been put back on the street to simply save money? Preliminary findings from a follow up study of all patients discharged from long term care in psychiatric hospitals in Northern Ireland between 1987 and 1992 indicate that most are pleased to be living in the community and are satisfied with their care. (Tonks,A. 1994) Dr Phil Timms, senior lecturer in community psychiatry at Guy's and St Thomas's United

Explain the evolution an expansion of hospitals throughout history

949 words - 4 pages ;spending on private health care construction (hospitals, medical buildings, and specialty care) increased 65% from 2000 to 2006,” (Holton, 2007). According to a 2005 survey of twelve U.S. sites, there are four main categories of hospital construction: new full-service hospitals or substantial expansion of existing general hospital capacity; new facilities or expansion of existing capacity for specific specialty services; total or partial

A Deeper Look at U.S. Heealthcare Delivery systems

790 words - 4 pages goals. Types of hospital systems include public hospitals, non-profit Hospitals, and private Hospitals. Public hospitals are financed and owned by local state or federal governments. Public hospitals receive money from the government and some public hospitals are associated with medical schools. Non–profit Hospitals are often community hospitals. Non-profit hospitals may also be linked with a religious denomination. The purpose of a Non–profit

Nursing Research Study Summary

1067 words - 4 pages % abstained from the question. There are 14 behavior variables and verbal abuse was the behavior variable selected for psychological violence to closer examine the frequency. Out of 214 participants the mean frequency was 52.6 in general hospitals, 28.2 in psychiatric specialty, 19.8 in maternity specialty, and 8.2 in pediatric specialty. Similarly there are 14 behavior variables for vertical violence and discrimination was selected to

Community Benefit Analysis

1720 words - 7 pages Internal Revenue Code because the Internal Revenue Service (IRS) has recognized the promotion of health for the benefit of the community, where medical assistance is afforded to the poor or where medical research is promoted, as a charitable purpose. (U.S. Government Accountability Office, 2008) Thus, not all hospitals are considered charitable organizations, creating a distinction between for-profit facilities and nonprofit facilities. Two

Magnet Status in Hospitals

1699 words - 7 pages Introduction: For hospitals to reach their peak in the healthcare world they must work to achieve a prestigious credential by the American Nurse's Credentialing Center ( Truth about nursing). In order to receive such a credential, hospitals must fulfill a set of criteria that will take a lot of work and reform within the hospital itself. To receive magnet status hospitals have to express the fourteen forces of magnetism along with the strict

Hospital Accreditation

749 words - 3 pages The Joint Commission has accredited hospitals for more than 50 years and today it accredits approximately 4,500 general, children's, long term acute, psychiatric, rehabilitation and surgical specialty hospitals, and maintains a unique accreditation program for critical access hospitals. The Joint Commission currently accredits approximately 80 percent of the nation's hospitals. Accreditation helps to inform and protect consumers, educate


2117 words - 9 pages professionals such as general practitioners, practice nurses, psychologists, physiotherapists, community health workers and pharmacists (WHO, 2008). PHC is universally accessible and socially appropriate first level care, generally provided in a community based setting, it is supported by integrated referral systems that prioritises those most in need whilst developing community and individual self-reliance and participation (Australian Medical Association

Similar Essays

Specialty Hospitals Finally Regulated By Ppaca

1254 words - 6 pages increased funding enables this patients’ group access to primary care, it does not facilitate their access to specialty care (Spatz et al., 2012). This, undoubtedly, is very critical since quarter of patients who visit community health centers get referred to see specialists (Spatz et al., 2012); hence the urgent need for strong distinctive legislation to better care for these patients. Clearly, specialty hospitals have very limited incentives and

Animal Assisted Therapy In Hospitals And Institutions

1337 words - 6 pages Animal Assisted Therapy in Hospitals and Institutions Animal Assisted Therapy (AAT) is a means of therapy that is intended to help the patient's recovery advance, the patients can express themselves with and through the pet. Patients are allowed to pet, groom and walk, ride or swim with the animal giving them a chance to nurture and find companionship with the pet. Some of the goals are to improve a patient's social, emotional and/or

Hospital Quality Alliance Assignment: Discuss The Hospital Quality Alliance And Its Significance For Hospitals

545 words - 2 pages In December 2002, the Hospital Quality Alliance (HQA) was launched by the organizations representing America's hospitals joined with consumer representatives, physician and nursing organizations, employers and payers, oversight organizations and government agencies. The HQA was introduced in order to incorporate a collaboration committed to making easily understood information regarding hospital performance readily available to the public

Experimental Study Comparing Two Chicago Based Hospitals For Patient Care And Readmission

1039 words - 5 pages How do we improve the quality and efficiency of health care within the U.S. with a special emphasis on improving coordination of care within hospitals? Policy Alternatives Examine the rate of hospital readmissions Across the U.S., many Medicare beneficiaries rely on hospitals servicing low-income areas for their care, placing additional financial pressure upon the institution. It is reported that each year within the U.S. one of five