GAO: Boutique hospitals treat healthier patients

The report could fuel congressional efforts to restrict referrals to specialty hospitals by physicians with ownership stakes.

By Markian Hawryluk, AMNews staff. June 16, 2003.

Washington -- New research showing that specialty hospitals might be "cherry-picking" their patients has renewed concerns that community hospitals may be stuck with the pits.

A report released by the General Accounting Office in May found that patients at specialty or "boutique" hospitals tended to be less sick than patients at general hospitals in the same communities.

The GAO said 21 of the 25 specialty hospitals studied had a less acute mix of patients. Two of the specialty hospitals had a more acute case load, while two treated comparable patients.

The study found that 17% of cardiac patients seen by specialty hospitals could be classified as severe cases, compared with 22% in general hospitals. About 5% of orthopedic cases in specialty hospitals were severe, compared with 8% in general hospitals.

In a letter to Reps. Bill Thomas (R, Calif.) and Gerald Kleczka (D, Wis.), who requested the study, the GAO said it had not considered the clinical or economic significance of the results. Nevertheless, the study may prompt the lawmakers to try to rein in specialty hospitals as they craft Medicare reform legislation this month.

"GAO's findings are of concern because they indicated that community hospitals generally care for the sicker, higher-cost patients, and Medicare's reimbursement does not adequately account for varying acuity levels in these different settings," Thomas said. "This disparity is problematic, and needs to be corrected to maintain fairness."