Texas' health care delivery system has changed dramatically over the past decade. Life-saving technologies and treatments, and the types of settings in which patients receive services have proliferated. Physicians, hospitals, and others have invested extensively in these technologies and settings. While physician investment in the health care system is not new, there have been considerable changes in health care coverage, financing, licensing, and regulatory environment over the past decade. These changes drive the debate over who should invest in facilities. Texas is also the uninsured capital of America, which creates competition for a dwindling supply of paying patients.
TMA strongly supports responsible physician investment in technology, facilities, services, or equipment. Physicians invest in facilities to improve the effectiveness, timeliness, and quality of the care they provide to their patients. The focus should be not on who owns the medical facility - a physician, a nonprofit entity, or a for-profit company - but on the quality of the facility and appropriateness of patient care. If overutilization or deviations from quality care are the issues, legislators should address those problems regardless of ownership, rather than limiting patient choice and innovation in the marketplace.
Medicine's 2009 Agenda
- Promote responsible ownership of all health care facilities, whether owned by a physician, hospital, or other provider. Responsible ownership demonstrates a commitment to patient safety as well as adherence to all appropriate regulations and laws, ongoing peer review and quality improvement, and transparency.
- Promote transparent transactions, governance, and ownership by physicians, allied health providers, and hospitals alike. Disclosure should apply to all financial relationships, including investors, employed physicians, paid directorships, etc.
- Focus efforts to ensure the highest quality of care at the most affordable costs.
- Support efforts to increase health care coverage for uninsured Texans.
- Strongly oppose efforts to limit investment opportunities for physicians such as limiting ownership of facilities, equipment, and services to certain types of providers.
- Physician-owned facilities are not new. Many of the nation's first hospitals were founded by physicians to assure appropriate care for their patients.
- Physicians have an obligation to advance improvements in the diagnosis, treatment, and care of patients, including innovations in medical technology and settings. Referrals to a physician-owned entity or entity to which the physician has a financial relationship must be based on the patient's medical needs and full disclosure of financial relationships to patients is appropriate.
- Physician-owned entities should adhere to all state and federal regulations; provide appropriate credentialing of physicians, clinical, and support staff; monitor utilization and quality; and adhere to all relevant regulations, laws, and TMA and AMA ethical guidelines.
2009 Federal Legislative Issue Briefs
U.S. Congressional main page