Fears that general hospitals would alter the care they provide to financially vulnerable patients as specialty hospitals capture insured and healthier patients have proved to be unfounded, according to a new study by the Center for Studying Health System Change. The study examines the impact that cardiac, surgical, and orthopedic specialty hospitals have had on general and safety-net hospitals in Indianapolis, Phoenix, and Little Rock, Ark.
A few general and safety-net hospitals noted serving more financially vulnerable patients, a result of losing insured patients to specialty hospitals, they claimed. More often, however, respondents, particularly safety net hospitals, attributed changes in payer mix to an overall increase in the number of uninsured in their respective markets. General hospitals also reported little change in patient acuity as they competed for patients with specialty hospitals. General hospitals that lost specialist physicians to specialty hospitals responded by employing specialists or aggressively aligning with specialists via contractual arrangements to encourage them to concentrate their practices at one hospital. This strategy also helped general hospitals rebound from initial losses in service volume to specialty hospitals.
