Health Affairs, doi: 10.1377/hlthaff.27.3.w165 (Published online March 18, 2008) © 2008 by Project HOPE	New Online   Senate Health Reform Bill   Rewarding Providers   Public Option Policy Brief   Health Reform & Abortion   Delivery System Reform

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Where Do I Send Thee? Does Physician-Ownership Affect Referral Patterns To Ambulatory Surgery Centers?

¹ Jon Gabel is a senior fellow at NORC at the University of Chicago in Washington, D.C.
² Cheryl Fahlman is a researcher at Mathematica Policy Research in Washington, D.C.
³ Ray Kang is a senior research associate at the Health Research and Educational Trust in Chicago, Illinois.
⁴ Gregory Wozniak is project manager, Clinical Performance Evaluation, at the American Medical Association in Chicago.
⁵ Phil Kletke is an associate professor, Department of Health Administration, at Governors State University in Chicago.
⁶ Joel Hay is an associate professor, Department of Pharmaceutical Economics, at the University of Southern California in Los Angeles.

^*Corresponding author.

Abstract

For more than three decades, Congress has struggled with potential financial conflicts of interest when physicians share in financial gain from nonprofessional services. This study asks the question: Are physicians who are leading referrers to physician-owned ambulatory surgery centers (ASCs) more likely to send Medicaid patients to hospital outpatient clinics than other patients? The comparison group is physicians who are leading referrers to non-physician-owned ASCs, using data from two metropolitan areas. Findings indicate that physicians at physician-owned facilities are more likely than other physicians to refer well-insured patients to their facilities and route Medicaid patients to hospital outpatient clinics. [Health Affairs 27, no. 3 (2008): w165-w174 (published online 18 March 2008; 10.1377/hlthaff.27.3.w165)]

Key Words: Access To Care, Business Of Health, Consumer Issues, Hospitals, Physicians

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