'Niche' Providers - Blast Fax

BryanLGH Medical Center, Lincoln, NE

Niche providers drain community health services
No matter what, no matter when, America's community hospitals are there, keeping the promise that the full spectrum of health care services will be there, 24/7, when needed. Americans expect it … and community hospitals deliver.  BUT, physician-owned boutique hospitals - “niche providers” - undermine the mission of community hospitals by providing only the most highly profitable services to the least severely ill patients.

BryanLGH Medical Center in Lincoln, NE, has for four consecutive years been rated by Solucient as one of the top 100 hospitals nationwide for cost-effective and high-quality cardiovascular care. The program extends well beyond Lincoln - medical staff and mobile cardiac units travel hundreds of thousands of miles a year not only in Nebraska, but also rural Kansas, Iowa and South Dakota. BryanLGH also supports 17 rural critical access hospitals and was just honored as a distinguished hospital program for clinical excellence. Investing heavily in much-needed, but unprofitable, community health care services, BryanLGH truly takes care of all the health needs of the community. But its ability to continue this wide range of services is being jeopardized by a group of local cardiac physicians who chose to invest in a specialty heart facility. With BryanLGH's award-winning cardiac program already in place, there was no  need for the specialty facility. The number of cardiac surgeries performed per month at BryanLGH by the boutique facility's physician-owners dropped from 110 to 10 in two years, siphoning millions of dollars that should be supporting important community health care services.

For more information, contact VP Public Policy, Brad Sher, at 402-481-8020.

The business model for niche providers is one in which owner- physicians refer patients to facilities in which the physicians have an ownership interest – heightening concern about conflict of interest in clinical decision-making.

  • Steering profitable cases or well-insured patients to niche providers diverts revenue from full-service community hospitals … revenue that is critical to
    keeping open money-losing services that communities need, like trauma centers, burn units and emergency departments. 
  • Hospitals lose money every day caring
    for people with complex health needs
    and little or no health insurance. Without
    revenue from profitable services to help
    offset this cost, how can hospitals continue
    caring for those who are truly in need? 
  • The Senate version of the Medicare Prescription Drug Benefit and Modernization Act of 2003 begins to address the problem by prohibiting physicians from referring patients to a specialty facility in which they have an ownership interest.

Senators and Representatives:  Help community hospitals keep the promise of care by protecting access to critical services.  Retain the Breaux-Nickles-Lincoln language on niche providers in the final Medicare Prescription Drug Benefit and Modernization Act of 2003.


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