Florida Health Care Joint Ventures Costly: Survey
Some of Florida's health care joint ventures are taking patients for a costly ride.
That's the finding of a controversial report compiled by the Florida Health Care Cost Containment Board, which was adopted by the board at a meeting last month.
Asked by the state legislature to take a look at health care joint ventures and their impact on cost, access, utilization, and quality of health care, the board spent more than 18 months compiling information from more than 3,000 such arrangements.
The results of the survey show that joint ventures do not increase access to rural or underserved indigent patients, something proponents of joint access have claimed.
'In my opinion, I'd say they don't improve access,' said HCCCB Executive Director James Bracher.
Although the news wasn't bad for all joint venture projects, the report found arrangements involving clinical laboratories, diagnostic imaging centers, and physical therapy/rehabilitation centers problematic.
'Results clearly indicated problems in either access, costs, charges, utilization, or quality (or in more than one of these areas) of health care services,' the survey said.
Clinical laboratories were divided into several categories. The survey shows that non-joint venture full-service labs render 'significantly more' services to Medicare, Medicaid, and self-pay patients than their joint venture counterparts.
The study shows that joint ventures are most prevalent in the area of diagnostic imaging. Florida imaging centers are 'far more profitable than most other types of non-joint venture Florida health care businesses,' it said.
Florida is one of 24 states that require physician approval to see a physical therapist. Many physicians refer patients to their own clinics.
Although joint venture physical therapy centers charge patients less per visit, the survey says, joint venture patients on an average have 43 percent more visits than non-joint venture patients.
Craig Crosby, executive director of the Florida Physical Therapy Association, said his organization endorses the study as 'an accurate reflection of practice patterns in the state.'
But not everyone sees the report, or the data on which it is based, as an accurate representation of the state of affairs in joint ventures.
Florida Medical Association (FMA) General Counsel John Thrasher said that he has problems with the way the data was interpreted by researchers and passed on to the advisory group that put together the report.
Mr. Thrasher pointed to an FMA report that outlines physicians' concerns with the survey methodology and the 'erroneous' ways in which the data was interpreted.
According to the survey, not all joint ventures have a negative impact on patient care. Joint ventures involving nursing homes and hospitals have no negative impact on patients, the report concludes.
And the data was inconclusive on the impact of joint ventures involving ambulatory surgical centers, durable medical equipment suppliers, home health agencies, and radiation therapy centers.
The HCCCB is expected to make its final legislative recommendations to the Legislature this month. Mr. Bracher predicted that the solution will not lie in an all-or-nothing proposition.
