By Mike Shields and Sarah Green
KHI News Service
TOPEKA, Feb. 20
The Kansas Health Policy Authority wants an extra 20 days to complete its report on specialty hospitals for the Kansas Legislature.
The original report deadline was March 1. But members of the health policy authority board on Tuesday rejected a draft of the report, sending it back to staff to be reworked. Members said they wanted a shorter, more focused document with clearer recommendations before shipping it to the Statehouse. They voted to ask for a 20-day extension to the deadline.
The report was requested by legislators last year wanting to know the health policy authority”s views on what should be done about the state law that defines hospitals. The health policy authority was created, in part, to provide lawmakers guidance on such issues.
Meanwhile, on Tuesday, members of the House Health and Human Services Committee weren”t waiting to see the report. They voted out of committee House Bill 2418, which would change current state law so that specialty and general hospitals would be separately defined. The change is something general hospitals have wanted, but specialty hospitals have opposed. The separate definitions are also what the health policy authority board decided Tuesday it wanted to recommend in its final report to lawmakers.
The definition issue is mostly considered important because it could, at some point, affect the way the hospitals are reimbursed for procedures covered by Medicare. For now, changing the legal definitions is expected to have little or no effect on how specialty or general hospitals operate or the underlying concerns about the competition between them.
Kansas has at least 11 of the nation”s hundred-some specialty hospitals, a disproportionate number. They are one of the fastest growing segments of the industry.
The health policy authority board”s discussion of the draft report made it clear few of its members are fans of specialty hospitals. Most who weighed in said they were worried or already convinced that the special hospitals are harmful to the state”s general hospitals because they siphon away healthier and more profitable patients.
The specialty hospitals typically focus on a handful of limited procedures such as hip replacement or heart surgery and treat fewer uninsured patients. They typically don”t have emergency rooms.
A recent Kansas Health Institute report concluded there was too little information to know yet if the specialty hospitals are actually harming the general hospitals, but several health policy authority board members said Tuesday they believe otherwise.
“They siphon off the best nurses because they pay more,” said board member Arneatha Martin. “They make the general hospitals look like the old county hospitals.”
Members Ned Holland and Susan Page, a general hospital administrator, also were critical of the specialty hospitals. So was Insurance Commissioner Sandy Praeger, a non-voting member of the board.
Holland was most vocal in pushing for a final report condemning the specialty hospitals as bad for the Kansas health care system. The board stopped short of that, instead calling for a report recommending the Legislature rework the legal definitions of the hospitals.
Not all KHPA board members were critical of the specialty hospitals.
“I do not see the evidence other than intuition that the specialty hospitals are bad,” said member Joe Tilghman. “And I don”t see the need for this group to protect big hospitals.”
Dr. Vernon Mills, another member, also has tended to temper fellow members” criticism of specialty hospitals when the topic arises at board meetings.
House committee acts
There was only brief debate on HB 2418 before members of the House Public Health and Welfare Committee voted the bill out of committee Tuesday.
Rep. Brenda Landwehr, R-Wichita, chairwoman, said it was due because the legal definitions haven”t changed for decades.
“Kansas is the leader on the number of specialty hospitals in the nation,” she said. “It”s time for the licenses to change because we haven”t done it for 30 years.”
Mike Shields and Sarah Green are staff writers for KHI News Service, which specializes in coverage of health issues facing Kansans. They can be reached at 785-233-5443.