Dear Administrator Verma:
Physician-owned hospitals (POHs) not only increase access and encourage innovation but provide the
best health care at the lowest cost. Nevertheless, the Affordable Care Act includes a provision that
strictly prohibits any new POH from participating in Medicare or Medicaid. It also prohibits existing POHs
from expanding unless they meet a very complicated set of criteria involving a percentage of Medicaid
admissions, population growth rate, and average bed capacity.
Because of this statutory barrier, we would like to express our support for a demonstration model that
will be submitted to the Center for Medicare and Medicaid Innovation (CMMI) which would allow POHs
to expand their facilities. The model increases patient choice, improves access, fosters patient
engagement, improves care quality and reduces inappropriate opioid use. It will not only empower
patients in their treatment decisions, but it will also improve competition and reduce the rapid pace of
hospital consolidation that has resulted in higher costs for beneficiaries and the Medicare and Medicaid
programs.
We urge you to approve this demonstration model which will demonstrate the value of POHs in
advancing quality and health outcomes for Medicare and Medicaid beneficiaries, while reducing
program costs.
Read full letter here
