SHM Converge Scientific Abstract ePoster Gallery-Physician Owned Hospitals: Mortality, Readmissions, and Cost Following Inpatient Medical and Surgical Admissions

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This study examined physician-owned hospitals (POHs) in the U.S. after the Affordable Care Act’s 2010 ban on POH expansion, using Medicare inpatient, outpatient, and carrier claims from 2009–2021. The goal was to compare trends in POHs and assess whether outcomes differed between POHs and non-POHs for common medical and surgical admissions.<br /><br />Researchers identified index admissions across 10 common DRGs and used propensity matching to compare POHs with non-POHs within each year, matching on hospital region and characteristics such as size, profit status, teaching status, urban location, and critical access designation. Outcomes were 90-day mortality, readmission, total spending, and hospital operating margin. Patient-level models also adjusted for age, sex, race/ethnicity, dual eligibility, comorbidity burden, DRG, and year.<br /><br />The ACA ban was associated with a decline in the number of POHs and several hospital closures. After matching, POHs showed slightly lower 90-day mortality (-0.89 percentage points), similar readmission rates, slightly lower total spending (-$823), and higher operating margins (+4%) compared with non-POHs.<br /><br />Overall, the findings suggest that POHs do not appear to cause substantial harm in these measured outcomes. The authors note possible residual confounding, but the results do not support major safety or cost disadvantages for POHs. Instead of restricting hospitals based solely on ownership type, the study suggests policymakers may be better served by applying broad rules on patient selection and self-referral across all hospitals. The authors also suggest that lifting the ban on POH expansion could potentially improve competition and help preserve access to care in increasingly consolidated healthcare markets.

Asset Subtitle

Afifah Khan

Meta Tag

Author List Afifah Khan, Jeffrey L. Schnipper, Tarun Ramesh, Tom Tsai

Category Research

Concept Physician-Owned Hospital

Concept Hospital Ownership

Concept 90-Day Mortality Rate

Concept 90-Day Readmission Rate

Concept Hospital Operating Margin

Distinguished Non-Finalist

Presenter Organization Brigham and Women's Hospital

Presenting Author Afifah Khan

Track Other

Keywords

physician-owned hospitals

Affordable Care Act

POH expansion ban

Medicare claims

hospital outcomes

propensity matching

90-day mortality

readmission rates

hospital spending

operating margin

Physician-Owned Hospital

Hospital Ownership

90-Day Mortality Rate

90-Day Readmission Rate

Hospital Operating Margin