By Mike Shields
KHI News Service
TOPEKA, Feb. 15
A bill that would narrow the state”s legal definitions of hospitals had representatives from specialty and general hospitals squaring off Thursday in the House Health and Human Services Committee.
House Bill 2418 has divided the hospital industry just as an unsuccessful definition bill did last year, though opponents and supporters alike agreed this year”s measure would have no likely effect on the hospitals” underlying worries about competition and profitability.
Kansas has at least 11 of the nation”s hundred-some specialty hospitals, a disproportionate number. It has been one of the fastest growing segments of the industry. Specialty hospitals usually focus on select surgical procedures such as hip replacements or cardiac treatments.
Some general hospital leaders claim that the specialty hospitals most of which don”t provide emergency services or treat as many Medicaid or uninsured patients as general hospitals
are able to “cherry pick” healthier and more profitable patients, leaving the general hospitals to cope with the burden of uncompensated care and sicker patients.
“Often we have lost patients to specialty hospitals, in many cases the higher-profit patients,” Wesley Medical Center CEO Sam Serrill told committee members. Wesley, which is owned by the for-profit HCA hospital chain, is in Wichita.
That said, Tom Bell, lobbyist for the Kansas Hospital Association, told lawmakers that the bill “does not deal with the overarching issue (of competition) and all that.”
Spokesmen for the specialty hospitals, which are often owned in part or whole by doctors, told lawmakers there is no need to change the law because the current definitions work fine. The current law makes no distinction between the two types of hospitals for licensing purposes.
The bill would exclude from the definition of general hospital any facility that doesn”t have a “dedicated emergency department.” Specialty hospitals typically do not.
The bill also would exclude from the definition any hospital that treats a narrow range of disorders, which is precisely how specialty hospitals earn their distinction with patients.
“It is our understanding that the current definitions have worked fine for the Kansas Department of Health and Environment in their licensing responsibilities, have not caused difficulties for the surveyors, have not endangered patients in any way or misled the public about what it means to be a hospital,” Scott Chapman, administrator for Manhattan Surgical Hospital in Manhattan, told the committee during his testimony opposing the bill.
Chapman said, “if this bill becomes law it would require every general hospital to have designated emergency services” with 24-hour physician staffing and that many small, rural hospitals would be hard-pressed to comply.
But
Kansas Health Institute senior policy analyst Sheldon Weisgrau, who authored a widely circulated report on the state”s specialty hospitals, told members that those hospitals would not be harmed because they operate under the federal regime that governs “critical access” hospitals.
Joe Kroll of Kansas Department of Health and Environment, which handles hospital licensing, told lawmakers the agency was neutral on the bill but that “it would be helpful to us to have the definitions tightened up.”
Mike Shields is a staff writer for KHI News Service, which specializes in coverage of health issues facing Kansans. He can be reached at
mshields@khi.org
or at 785-233-5443, ext. 123.