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Healthcare Finance in The United States

In United States the Congress had passed the Medicare Prescription Drug, Improvement and Modernization Act of 2003 or MMA and with this imposed a stoppage for 18 months on the starting of new physician owned specialty hospitals. At the same time, they also wanted to know the position regarding certain matters of physician owned heart, orthopedic and surgical specialty hospitals through MedPAC. The team visited sites, made legal analysis and met the share owners in these hospitals and finally presented a report to the Congress. It had also gone through the cost reports received from Medicare and inpatient claims of 2002, which was the most recent at that time. This will naturally form the basis of such hospitals being permitted or not. (Physician-owned specialty hospitals)

The findings of this committee showed that:-

Physician owned hospitals generally treated patients who had less severe problems and concentrated on specific diagnosis related groups and the reason for both of this was that these were expected to be more profitable than other patients.

These hospitals do not treat as many Medicaid patients as community hospitals.

Regarding the costs of patients in these hospitals for


The biggest problems in the management of hospitals come from physicians and renowned physicians are sought for empanelment by hospitals. The physicians then continually force the hospitals to upgrade their infrastructure and also charge heavy fees from the patients. At the end of the services by the physicians, it is they who get the biggest returns. It is also difficult to retain the physicians as they leave at the earliest opportunity, and this statement is from one of the promoters of the hospital, GW Capital. They are now investing money in the concept of physician managed private hospitals. This resulted in its investment of Rs 150 million or about 3 million dollars in buying a 26 percent stake in another hospital group in Hyderabad, in 2000 called the Care Group. That group has expanded very fast and now has over a 1000 beds in its operations in six centers. (Doctors in arms) Thus the costs of the hospitals will require about 12 million dollars for a 1000 bed operation. At the same time, not all hospitals are made with money in mind and there are hospitals in Chennai or Madras in India which have 150 physicians, 500 nurses and 371 Para-medical staff. The entire team works within a budget of Rs 120 million or 2.4 million dollars. (Healing Ministry of the Madras Diocesan Medical Board) This hospital is run by a religious mission and its objective is to provide service to the people and this hospital does not want to make money, but run at break even costs.

Differences among types of hospitals:

To find this aspect out, there were discussions with the physicians who were investing in these hospitals. The cardiologists and surgeons want to admit their patients, perform the required procedures and have the patients recover with minimum disturbance. They believe that community hospitals cannot match their services as those hospitals have a variety of services and missions that they have to undertake. The direct control by the physicians help to increase productivity through less disturbances to the schedules in operating room which come from the emergency cases that come about, decreasing the down time between operations between two different sur

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Approximate Word count = 1460
Approximate Pages = 6 (250 words per page double spaced)


  

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