Physician-owned, limited-service hospitals (fewer than 200) typically offer the most profitable services to less acutely ill patients, and serve few uninsured or Medicaid patients. They have physician-owners who self-refer to the hospital. This enables physician-owners to pay themselves for referring patients to the facilities they own. In contrast, full-service community hospitals have deep roots in the community and provide a wide range of services and care for all patients who come to our emergency department doors.

The Dec. 6 letter from a group of physicians backed by the Physician Hospitals of America is full of misinformation and does a great disservice to the full-service community hospitals across the nation that care for patients 24 hours a day, seven days a week. Limited-service hospitals, if left unchecked, can threaten a community's health care safety net, which community hospitals anchor. IHA and AHA believe you deserve the facts on this important issue and have refuted myths being circulated by physician-owned, limited-service hospitals.

Myth #1: "Current congressional proposals would shutter physician-owned, limited-service hospitals."

Fact: Under current proposals being discussed, hospitals that had physician-ownership arrangements will be able to continue to have physicians self-refer and maintain their ownership interests, with certain disclosure requirements to patients.

Myth #2: "Physicians have little or no economic incentive to steer patients to one hospital over another."

Fact: Physicians with an ownership stake in specialty hospitals have considerable economic self-interest in the volume of referrals they generate. Physician-owners are paid their professional fee for the procedure, a share of the facility fee, and then again as the value of their investment increases as a direct result of the self-referral.

Myth #3: "Physician-owned, limited-service hospitals are just like the Mayo Clinic and Cleveland Clinic."

Fact: Physician-owned, limited-service hospitals are very different than the esteemed Mayo Clinic and Cleveland Clinic that are physician-run-not owned-non-profit, full service hospitals and do not embody the conflict of interest inherent in the "physician-owned" facilities.

Myth #4: "Limited-service hospitals provide higher quality care than full-service hospitals. Community hospitals aren't willing to share quality data."

Fact: There's no significant difference in care outcomes between the two types of hospitals, according to a peer-reviewed study in the New England Journal of Medicine. Researchers suggested that the limited service model does not yield better outcomes. The AHA and IHA support public reporting of quality measures for hospitals allowing for "apples" to "apples" comparison and work within the Hospital Quality Alliance to encourage additional quality reporting.

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