Sparking up an age-old debate between physician-owned hospitals and non-profit hospitals, a new bill passed by the U.S. House of Representatives this month will hamper the expansion of facilities owned by doctors as reported by the Rapid City Journal this week. See article

The concern stems from cases where a patient has an injury and is then scheduled for surgery in the hospital in which the physician owns. It is difficult to monitor the interests of each doctor and whether he/she simply wants to be sure that the patient is receiving the proper care, or if there is a conflict of interest.

One side of the coin is that many doctors run a physician-owned facility to avoid the bureaucracy that typically comes with a larger hospital. Opposing opinions suggest that other factors are considered when there is profit involved, and the existence of these hospitals is due in part to a loophole in a federal law.

It isn’t possible to say that this issue is always a conflict of interest, or strictly to see that the patient receives the proper care. Every facility is different and instead should be monitored accordingly.

Healthcare payers can ease their concerns of over-utilization, while ensuring proper care for their patients by using an independent review organization like AllMed to help make medical necessity determinations for their patients.