Croce must have enjoyed it when big, tough guys got their comeuppance because both Leroy and Jim, legendary for their toughness at the beginning of their respective songs, got unexpectedly clocked in the end.
Well, it happened twice last week, one locally and one nationally.
Bad, Bad Leroy Brown
On the big stage, CMS issued its final rule for how off-campus hospital facilities will be reimbursed in 2017. This summer the agency proposed paying new and future hospital-owned off-campus facilities according the physician practice fee schedule, not as a hospital outpatient department.
This change will save CMS $500 million annually. Said another way, it will reduce hospital revenue by half a billion dollars. The big, bad AHA protested loudly, of course.
Normally the AHA wins its priority lobbying battles, but in the final rule CMS allowed for only very narrow exceptions to the original proposed rule.
More narrowly, the 7th Court of Appeals ruled against the proposed merger of Advocate Health Care and NorthShore University HealthSystem in north Chicago. The appellate court said the lower court’s ruling in favor of the merger was ‘erroneously flawed’ and sent it back to them with instructions to do better.
Here’s to “tugging on Superman’s Cape”!
Of course, the two systems were aghast at the ruling. Here’s the priceless quote,
“We believe that blocking this merger will be a loss to consumers and further underscores the conflicting message with the objectives of the Affordable Care Act.”
Again, we see that hospital systems believe they can act in non-competitive ways just because they first saluted the Affordable Care Act. The court of appeals said no and yanked hard on the cape.
Eventually Gravity Wins
The whitepaper Eventually, Gravity Wins: The Case for Independent Physicians by Tim Coan, CEO of ALN Medical Management is available for free download. To receive a complimentary copy of this paper please follow the link below.
“In the six years since the passage of the Patient Protection and Affordable Care Act (ACA), the U.S. healthcare industry has been transformed at an incredible rate. This process has caused many to conclude that there is no viable role for independent physician practices in the future. Frankly, there seems to be quite a bit of evidence to support this claim. However, we beg to differ.”