Editor's Page


Win Some, Lost Some

Dan O'Connor, Editor Winning isn't everything...

  •   In Owensboro, Ken., a state moratorium on new health facilities and a hospital's request for a hearing to determine if the proposed surgery center would be in competition with it have forced an otolaryngologist to defer his dreams of building an outpatient surgery center.

    It's the only thing...

  •   In Hilton Head, S.C., a physicians group and a hospital are playing a game of legal chicken: If the doctors agree to drop legal action delaying a large addition to a medical center, the hospital would agree not to oppose the physicians' state Certificate of Need (CON) application.

    Dan O'Connor, Editor

    Worth striving for...

  •   And in Hammond, La. (and on page 32 of this issue), a federal appeals court ruled that a public hospital did not violate antitrust laws when it demanded managed care contracts that excluded the competing surgery center across the street.

    With all due respect to legendary football coach Vince Lombardi and the famous motivational aphorism he coined in 1965, these words are indisputably part of the hospital phrase book in 2003.

    Hospitals have taken Coach Lombardi's win-at-all-cost competitive pathology to a new level. Any entity that dares open a surgical facility in the shadow of a hospital - loosely defined as the same ZIP code - can expect stiff opposition. Hospitals can use many tactics to fight competing surgery centers. They can delay them by challenging CONs. They can hurt them by negotiating exclusive managed care contracts. And they can spite them by withholding hospital privileges of any surgeon who self-refers a patient to a facility that just happens to be owned by that physician.

    But I'm convinced that they can never defeat them. And in the end, isn't winning the only thing worth striving for?


    As we're on the topic of fights and foes, MedPAC has advised Congress to freeze ambulatory service center payments in 2004 and to equalize ASC and hospital outpatient payment rates. See page 48 for an in-depth look at what this could mean for you.