Specialty versus community hospitals: Referrals, quality, and community benefits

Health Affairs

Volumn 25, Issue 1, 2006, Pages 106-118

  Greenwald, Leslie ^a   Cromwell, Jerry ^b   Adamache, Walter ^b   Bernard, Shulamit ^b   Drozd, Edward ^b   Root, Elisabeth ^b   Devers, Kelly ^b  

^a RTI INTERNATIONAL   (United States)

^b VIRGINIA COMMONWEALTH UNIVERSITY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

COMMUNITY HOSPITAL; COMPARATIVE STUDY; CONFERENCE PAPER; ECONOMIC ASPECT; ECONOMICS; HEALTH CARE QUALITY; HOSPITAL; INTERVIEW; ORGANIZATION AND MANAGEMENT; PATIENT REFERRAL; PUBLIC RELATIONS; UNITED STATES;

COMMUNITY-INSTITUTIONAL RELATIONS; ECONOMIC COMPETITION; HOSPITALS, COMMUNITY; HOSPITALS, SPECIAL; INTERVIEWS; OWNERSHIP; QUALITY OF HEALTH CARE; REFERRAL AND CONSULTATION; UNITED STATES;

EID: 32044471338     PISSN: 02782715     EISSN: 02782715     Source Type: Journal    
DOI: 10.1377/hlthaff.25.1.106     Document Type: Conference Paper

References (18)

1. U.S. Government Accountability Office, Specialty Hospitals: Geographic Location, Services Provided, and Financial Performance, Pub. no. GAO-04-167 (Washington: CAO, 2003);
2. L. Casalino, K.J. Devers, and L.R. Brewster, "Focused Factories? Physician-Owned Specialty Facilities," Health Affairs 22, no. 6 (2003): 56-67;
3. Medicare Payment Advisory Commission, Report to the Congress: Physician-Owned Specialty Hospitals (Washington: MedPAC, 2005).
4. J. Cromwell et al., Specialty Hospital Evaluation, Report to the Centers for Medicare and Medicaid Services under Contract no. 500-00-0024, TO no. 12, section 3 (Waltham, Mass.: RTI, June 2005).
5. MedPAC, Report to the Congress.
6. While "call" arrangements worked reasonably well in some markets, in others there was tension between specialty hospital physicians and general hospital managers over compensation and hours.
7. GAO, Specialty Hospitals;
8. MedPAC, Report to the Congress.
9. J. Cromwell et al., Specialty Hospital Evaluation, Final Report to the CMS (Waltham, Mass.: RTI, September 2005).
10. H.S. Luft et al., Hospital Volume, Physician Volume, and Patient Outcomes: Assessing the Evidence (Ann Arbor, Mich.: Health Administration Press, 1990);
11. J. Cromwell, J.B. Mitchell, and W.B. Stason, "Learning by Doing in CABG Surgery," Medical Care 28, no. 1 (1990): 6-18.
12. P. Cram, G.E. Rosenthal, and M.S. Vaughan-Sarrazin, "Cardiac Revascularization in Specialty and General Hospitals," New England Journal of Medicine 352, no. 14 (2005): 1454-1462.
13. We compared specialty hospitals with not-for-profit competitors only, since not-for-profit hospitals receive special consideration (exemption from income, property, and sales taxes) in exchange for providing community benefits, particularly uncompensated care. For-profits receive no such special consideration.
14. N.M. Kane and W.H. Wubbenhorst, "Alternative Funding Policies for the Uninsured: Exploring the Value of Hospital Tax Exemption," Milbank Quarterly 78, no. 2 (2000): 185-212;
15. J.L. Frizzell, "Nonprofit Hospitals and Charitable Tax Exemptions: Re-Examining the Quid Pro Quo," New Hampshire Bar Journal 39, no. 4 (1998): 30-35;
16. W.M. Gentry and J.R. Penrod, "The Tax Benefits of Not-for-Profit Hospitals," in The Changing Hospital Industry: Comparing Not-for-Profit and For-Profit Institutions, ed. D.M. Cutler (Chicago: University of Chicago Press, 2000), 285-324.
17. W.M. Gentry and J.R. Penrod, "The Tax Benefits of Not-for-Profit Hospitals," in The Changing Hospital Industry: Comparing Not-for-Profit and For-Profit Institutions, 285-324, 2000 Ibid.
18. See also K.J. Devers, L.R. Brewster, and L.P. Casalino, "Changes in Hospital Competitive Strategy: A New Medical Arms Race?" Health Services Research 38, no. 1, Part 2 (2003): 447-469.