Doctors Can't Own Hospitals... Why the Stark Law Is a Joke.

Описание: Doctors Can't Own Hospitals... Why the Stark Law Is a Joke and Why the Patient Needs to be Put First.

The Stark Law passed in 1989 states that doctors that participate in Medicare cannot self-refer... that's they cannot refer patients to medical facilities (e.g. a hospital) that they own.

The Stark Law was put in place to prevent financial incentives that would bias doctors to:
1) Cherry Pick... only seeing patients with high-paying commercial insurance and not lower paying Medicare and Medicaid insurance.
2) Lemon Drop... not seeing (i.e. 'dropping') patients who are complicated, harder to treat and less financially lucrative.
3) Order too many tests and procedures, thus creating overutilization and higher healthcare costs.

However... the Stark Law is a Joke and is routinely circumvented. Here are 3 examples:
1) There is a 'Safe Harbor' that allows surgeons and other 'proceduralist' doctors (e.g. gastroentrologists) to self-refer to ambulatory surgery centers that they own.
2) Doctors and hospitals systems co-own Joint Venture hospitals where the doctors are the minority owners and the doctors still have the above perverse financial incentives.
3) The RVU-based compensation system of physicians employed by hospitals pays doctors more the more services they perform... essentially compensating doctors on the basis of commission and creating the same financial incentives that the Stark Law was meant to prevent.

The issue is not whether doctors or hospital administrators own and run hospitals.

Rather the issue is, 'Does whoever is running the hospital put the patient first?' Both doctors and hospital administrators are capable of putting patients first. Conversely, both parties are also VERY capable of NOT putting patients first.

What's the solution?

1) Transparency in compensation incentives. The dollar amount does not need to be revealed, but exactly how doctors and hospital administrators are paid should be plainly communicated to patients and the public.

2) Transparency in accountability. The names of the people who establish clinical policies at hospitals (and insurance companies) should be published as a public display that they are taking responsibility for these policies. This approach is similar to the way a CEO must publicly 'sign off' on a company's financial statements as required by Sarbanes-Oxley.

Sources:
https://www.aha.org/fact-sheets/2023-....

https://www.fiercehealthcare.com/prov...


AHealthcareZ is 400+ Healthcare Finance Educational Videos.

💥 BOOK: Check out Dr. Bricker’s Book 16 Lessons in the Business of Healing here: https://www.ahealthcarez.com/healthca...

AHealthcareZ Viewers Include: Employee Benefits Professionals, HR, CFOs, Insurance Brokers, Benefits Consultants, Doctors and Nurses in Leadership Roles, Hospital and Health System Administrators, Health Insurance Carrier and PBM Professionals, Pharma and Med Device Professionals, Academic Professors and Students in Healthcare Administration and Public Health.

90,000+ Views Per Month Across All Platforms.

Visit AHealthcareZ.com to Subscribe to the Healthcare Finance Video Newsletter.