Florida clinical laboratories owned by physicians performed almost twice as many diagnostic tests per patient as facilities that were not owned by physicians. And the average charge in a physician-owned lab was $43 per patient, compared with $20 per patient in the other labs.
These were key findings of a large study of Florida health care facilities conducted by the state's Health Care Cost Containment Board (HCCCB) and reported in the Aug. 12 issue of the medical device newsletter M-D-D-I Reports. The study found that clinical labs owned by referring physicians performed 3.3 tests per patient versus 1.7 tests for the non-joint venture labs, a 94% higher utilization rate. Further, the HCCCB report stated, 'All of the objective indicators of quality reported by both groups indicate that non-joint venture labs provide a higher quality product than their joint venture counterparts.'
The study was mandated by the Florida legislature to evaluate the impact of physician ownership on the state's health care facilities. The HCCCB analyzed responses of 2,669 health care providers in 10 categories: ambulatory surgical centers, clinical laboratories, diagnostic imaging centers, durable medical equipment suppliers, home health agencies, hospitals, mental health treatment centers, nursing homes, physical therapy/rehabilitation therapy centers.
The report found that at least 40% of physicians in direct patient care in Florida are involved in joint ventures to which they can refer patients. In particular, physicians either partly or wholly owned 93% of responding diagnostic imaging centers, 80% of radiation therapy centers, 75% of ambulatory surgical centers, 60% of clinical laboratories, and 40% of physical therapy/rehabilitation facilities.
Physician involvement in diagnostic imaging centers was so high (93%) that the HCCCB said that comparisons between joint venture and non-joint venture facilities 'are problematic in that virtually all these facilities in Florida are owned by physicians.'
According to the HCCCB, the study results 'clearly indicate problems in either access, costs, charges, utilization, or quality (or in more than once of these areas) of health care services for clinical laboratories, diagnostic imaging, and physical therapy/rehabilitation centers.' The board also said that these physician-owned joint ventures 'do not increase accesss to rural or underserved indigent patients.'
Florida Medical Association officials acknowledged that there may be some abuse of joint ventures by some doctors. They said they would welcome stage guidelines on physician ownership arrangements. They will probably get them.
Our man in Washington
When you turn to our Washington Report this month, you may notice the byline, David Albertson, and think we have a new Washington correspondent. Not so. Dave has been writing our Washington column for a long time.
Albertson, a graduate of Kalamazoo (Mich.) College with a bachelor's degree in economics, has been MLO's Washington correspondent since 1985. He has covered the DRG era, the AIDS epidemic, the annual budget reconciliations, numerous Medicare reimbursement changes, the passage of CLIA '88--anything and everything that affects the health care industry in general and labs in particular. He also wrote our insightful February cover story this year, 'The Growing Crackdown on Laboratory Fraud and Abuse.'
We thought it was long since time to recognize Dave's contribution by carrying his byline on each Washington Report. Don't miss his column this month on the new OSHA regulations pertaining to bloodborne pathogens. And his ongoing coverage in the months ahead on the final regs to implement CLIA '88.
