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AMA vs. AHA: Should Congress Include the Physician Self-Referral Provision in the Farm Bill?

by Barbara Kram, Editor | April 22, 2008
Hospital and physician
groups don't agree
on this issue
AHA and AMA statements follow:

AHA STATEMENT: CONGRESS SHOULD INCLUDE THE PHYSICIAN SELF-REFERRAL PROVISION IN THE FARM BILL FOR PATIENTS AND COMMUNITIES

Congress has long been concerned about physician self-referral and the conflict of interest it creates between a patient's health care needs and physicians' financial interests. In fact, over the last year, the House of Representatives has twice passed a ban on physician self-referral to hospitals in which a physician has an ownership interest. Clearly Congress is openly and strongly committed to addressing this issue as quickly as possible.
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The provision being considered in the Farm Bill would not close physician-owned hospitals. It would simply stop physician self-referral to new facilities. Studies have shown that many physician-owned facilities treat far fewer patients who are sicker or poor and lessen patient access to emergency and trauma care. Research also reveals that when physician-owned facilities enter a community, it results in increased utilization rates. Studies also have shown that physician-owned hospitals, as a whole, do not deliver the promised benefits of higher quality and lower cost. These include studies in peer-reviewed journals such as The New England Journal of Medicine and The Journal of the American Medical Association as well as reports by government agencies and advisory groups such as the Medicare Payment Advisory Commission and the U.S. Government Accountability Office. The government's own Congressional Budget Office found that banning self-referral to new facilities would reduce Medicare spending by $2.4 billion over ten years, so taxpayers will win. In short, these facilities siphon off the resources that full-service hospitals need to provide the range of services needed in everyday emergencies as well as in times of community crisis.

Including a provision in the farm bill - or any bill - to ban self-referral would protect patient access to vital health care services, as well as ensure fair competition in health care. That's why Congress must act on their commitment and end the practice of self-referral.

Editor's note: For a listing of research addressing self-referral, go to
www.aha.org/aha/press-release/2008/080418-st-physowned.html

About AHA

The AHA is a not-for-profit association of health care provider organizations and individuals that are committed to the health improvement of their communities. The AHA is the national advocate for its members, which includes 5,000 hospitals, health care systems, networks, other providers of care and 37,000 individual members. Founded in 1898, the AHA provides education for health care leaders and is a source of information on health care issues and trends. For more information, visit the Web site at www.aha.org.