The time is now for physician-owned hospitals, with Carlos Cardenas, M.D., president of Physician-Led Healthcare for America
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For the first time, CMS isn't asking whether physician-owned hospitals should be part of Medicare's care delivery models — it's asking how.
For the first time, CMS isn't asking whether physician-owned hospitals should be part of Medicare's care delivery models — it's asking how.
Carlos Cardenas, M.D., a practicing gastroenterologist, founder and chairman of DHR Health in Texas' Rio Grande Valley, and president of Physician-Led Healthcare for America, joins Medical Economics Senior Editor Richard Payerchin to explain why that distinction matters. They cover how Section 6001 of the ACA froze competition in hospital markets, what the data actually shows about cost and quality at physician-led facilities, how to address the overutilization criticism, the patchwork of state and federal rules governing physician ownership, and what it will take to move the needle in Congress.
CMS has published its proposed 2027 Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals (IPPS), including a request for information about participation of physician-owned hospitals in Medicare’s new Transforming Episode Accountability Model (TEAM). Public comments on the CMS request for information are due June 9. The IPPS is a 576-page document, but the relevant section can be found by searching for: “Hospital with Physician Ownership Request for Information”.
Music Credits:
Chasing the moment by Cephas - stock.adobe.com
A Textbook Example by Skip Peck - stock.adobe.com
Editor's note: Episode timestamps and transcript produced using AI tools.
0:00 — Sponsor message Copic medical liability insurance.
0:27 — Cold open: Dr. Cardenas on CMS's shift in framing physician-owned hospitals
0:52 — Intro: Austin Littrell previews the episode and the June 9 CMS public comment deadline
1:55 — Guest introduction: Dr. Cardenas and Physician-Led Healthcare for America
3:11 — The "landmark moment": What the CMS request for information actually signals
3:49 — How the ACA's Section 6001 restricted physician-owned hospitals and froze competition
4:31 — The economic environment for medical practice over the last 15 years
7:26 — Why CMS's request for information is a meaningful seat at the table
9:49 — P2 Management Minute: Keith Reynolds
10:37 — A 2023 study showing Medicare could have saved $1B+ if care had been delivered at physician-owned hospitals
12:34 — Addressing the overutilization criticism
13:34 — Cherry-picking patients: Is it real?
15:15 — Reconciling state corporate-practice-of-medicine laws with federal limits on physician hospital ownership
18:07 — What it will take to get Congress to act on physician ownership legislation
20:02 — If the Medicare inpatient rule produces no change, what comes next?
21:28 — A message to primary care physicians
22:22 — Outro and CMS public comment reminder