Specialty Heart Hospitals Increase Rate of Surgeries

But the for-profit centers may be offering needed services, study suggests

By Ed Edelson
HealthDay Reporter

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TUESDAY, March 6 (HealthDay News) -- So-called specialty hospitals, which focus on one disease or condition and are often owned by the affiliated physicians, are an emerging trend in U.S. health care.

And a new study finds that in regions where a cardiac-care specialty hospital opens, there is a significant increase in artery-opening procedures such as bypass surgery and angioplasty, even if neighboring general hospitals offer comparable heart care.

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But it's not clear that such specialty cardiac centers are performing too many of the procedures just to make money, said study lead author Dr. Brahmajee K. Nallamothu.

"They could be opening up in areas where the physicians or companies understand there's a great need, and so they are appropriately doing more procedures," said Nallamothu, an assistant professor of internal medicine at the University of Michigan.

But, he acknowledged, "the most concerning idea is that there is a financial incentive."

The study is published in the March 7 issue of the Journal of the American Medical Association.

Nallamothu and his colleagues looked at data on cardiac procedures in 306 Medicare hospital referral regions (HHRs) -- 13 regions where for-profit specialty hospitals opened between 1995 and 2003; 142 where general hospitals started new cardiac programs; and 151 regions where no new cardiac programs were opened.

Rates of cardiac procedures increased 19.2 percent in those areas where specialty cardiac hospitals opened. This compared with an increase of 6.5 percent in areas where general hospitals started new cardiac programs and 7.4 percent in areas where no new programs were introduced.

The federal government has shown concern about the specialty hospital trend. An 18-month embargo was placed on the opening of new specialty centers in 2003, and it was then was extended for a year. Now, the U.S. Centers for Medicare and Medicaid Services is developing a plan to "level the playing field" by changing the payment system to general hospitals so it matches payments made to specialty centers.

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