Comments on: Building Something Worth Building For All Patients http://healthaffairs.org/blog/2008/03/24/building-something-worth-building-for-all-patients/ The Policy Journal of the Health Sphere Tue, 07 Feb 2012 22:23:43 +0000 hourly 1 By: Farmanux News http://healthaffairs.org/blog/2008/03/24/building-something-worth-building-for-all-patients/comment-page-1/#comment-17021 Farmanux News Tue, 25 Mar 2008 03:00:20 +0000 http://healthaffairs.org/blog/2008/03/24/building-something-worth-building-for-all-patients/#comment-17021 [...] Jerry Cromwell and Chris Cassel. To paraphrase the great American architect, Frank Lloyd […] Read more… Fatal error: Call to undefined function add_submit_it() in [...] [...] Jerry Cromwell and Chris Cassel. To paraphrase the great American architect, Frank Lloyd […] Read more… Fatal error: Call to undefined function add_submit_it() in [...]

]]> By: Arvind Cavale http://healthaffairs.org/blog/2008/03/24/building-something-worth-building-for-all-patients/comment-page-1/#comment-17020 Arvind Cavale Tue, 25 Mar 2008 02:04:45 +0000 http://healthaffairs.org/blog/2008/03/24/building-something-worth-building-for-all-patients/#comment-17020 Great set of observations, Dr. Burgess. Being an Endocrinologist in solo practice, I am not very familiar with ASC's but completely agree with idea that ownership brings with it a great sense of responsibility and attention to quality and efficiency. These are the exact attributes that are glaringly missing or at best found sparingly in hospitals. Obviosuly there are procedures that require a hospital setting. But using ASCs for other procedures will clearly provide superior care with greater effiiency. I also agree that those self-paying patients definitely include uninsured patients. When we refused an unacceptable contract from a Medicaid HMO that refused to negotiate with its last in-network Endocrinologist in the whole County (me), several patients who are covered by that entity decided to continue care with us paying cash because they knew they would not be able to get similar one-on-one services at a university hospital-based clinic. Finally, I have always wondered why Medicaid is the lowest payer (if it ever pays). Here in PA it pays 30% of Medicare, which I believe is at 2005 level. And our Governor wants to expand such "coverage" to all the uninsured! I wonder if you put on your Congressional hat you can figure out why... Great set of observations, Dr. Burgess. Being an Endocrinologist in solo practice, I am not very familiar with ASC’s but completely agree with idea that ownership brings with it a great sense of responsibility and attention to quality and efficiency. These are the exact attributes that are glaringly missing or at best found sparingly in hospitals. Obviosuly there are procedures that require a hospital setting. But using ASCs for other procedures will clearly provide superior care with greater effiiency.

I also agree that those self-paying patients definitely include uninsured patients. When we refused an unacceptable contract from a Medicaid HMO that refused to negotiate with its last in-network Endocrinologist in the whole County (me), several patients who are covered by that entity decided to continue care with us paying cash because they knew they would not be able to get similar one-on-one services at a university hospital-based clinic.

Finally, I have always wondered why Medicaid is the lowest payer (if it ever pays). Here in PA it pays 30% of Medicare, which I believe is at 2005 level. And our Governor wants to expand such “coverage” to all the uninsured! I wonder if you put on your Congressional hat you can figure out why…

]]> By: Farmanux News http://healthaffairs.org/blog/2008/03/24/building-something-worth-building-for-all-patients/comment-page-1/#comment-17016 Farmanux News Mon, 24 Mar 2008 23:01:10 +0000 http://healthaffairs.org/blog/2008/03/24/building-something-worth-building-for-all-patients/#comment-17016 [...] Editor’s Note: Today, Rep. Michael Burgess (R-TX) kicks off a series of posts on Jon Gabel’s article “Where Do I Send Thee? Does Physician-Ownership Affect Referral Patterns To Ambulatory Surgical Centers?,” published March 18 on the Health Affairs Web site. The series will also feature posts from Jerry Cromwell and Chris Cassel. To paraphrase the great American architect, Frank Lloyd […] Read more [...] [...] Editor’s Note: Today, Rep. Michael Burgess (R-TX) kicks off a series of posts on Jon Gabel’s article “Where Do I Send Thee? Does Physician-Ownership Affect Referral Patterns To Ambulatory Surgical Centers?,” published March 18 on the Health Affairs Web site. The series will also feature posts from Jerry Cromwell and Chris Cassel. To paraphrase the great American architect, Frank Lloyd […] Read more [...]

]]> By: RobertBurney http://healthaffairs.org/blog/2008/03/24/building-something-worth-building-for-all-patients/comment-page-1/#comment-17011 RobertBurney Mon, 24 Mar 2008 20:17:15 +0000 http://healthaffairs.org/blog/2008/03/24/building-something-worth-building-for-all-patients/#comment-17011 I too am a physician (anesthesiologist) with experience in ASCs. We were denied coverage by MEDICAID, because the state (MA) "did not want to license yet another facility where MEDICAID patients could go for healthcare." So, the surgeons took their MEDICAID patients to the hospital and brought other patients to us. We did accept a number of non-insured patients, because our charges were typically half those of the hospital. And we paid taxes, which the hospital did not. We did everything faster, better, and cheaper than anybody, because our physician-owners demanded it. One day, we did eight tubal ligations in 4 hours. I'll let Dr. Burgess comment on the efficiency of that schedule. Surgeons didn't bring patients to us because they were owners, they came because we did a better job. I too am a physician (anesthesiologist) with experience in ASCs. We were denied coverage by MEDICAID, because the state (MA) “did not want to license yet another facility where MEDICAID patients could go for healthcare.” So, the surgeons took their MEDICAID patients to the hospital and brought other patients to us. We did accept a number of non-insured patients, because our charges were typically half those of the hospital. And we paid taxes, which the hospital did not.
We did everything faster, better, and cheaper than anybody, because our physician-owners demanded it. One day, we did eight tubal ligations in 4 hours. I’ll let Dr. Burgess comment on the efficiency of that schedule. Surgeons didn’t bring patients to us because they were owners, they came because we did a better job.

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