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HMOs support teaching hospitals.

HMOs make higher payments to major teaching hospitals than to non-academic centers, according to a study by The Medstat Group. The analysis found that HMOs pay major teaching hospitals about 12 percent more than non-teaching hospitals. These findings contradict the Administration's assumption that health plans are not sending their patients to teaching hospitals and paying for the increased costs associated with these facilities. These findings come from a study commissioned by the American Association of Health Plans (AAHP).

The Medstat Group used a database of more than 4 million privately insured individuals covered by large employers. It found that HMOs have utilization rates at academic centers comparable to fee-for-service plans. In fact, according to Medstat, HMOs admitted a slightly larger share of their patients to major teaching hospitals than fee-for-service plans.

The study is being used by AAHP in an effort to counter the Administration's plan to reduce payment to Medicare HMOs. Overall, the Administration's budget proposal cuts $34 billion in payments to Medicare HMOs. Two areas targeted to achieve these cuts are graduate medical education and disproportionate share hospital payments to Medicare HMOs, which would be removed from the Medicare payments to HMOs under the Administration's proposal.

--James A. Hawkins is Publisher of Healthcare Briefings, a newsletter available in print, on cassette, via fax, and on computer disk. He can be reached at 800/338-5486.
COPYRIGHT 1997 American College of Physician Executives
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Title Annotation:Short takes: news at deadline
Author:Hawkins, James A.
Publication:Physician Executive
Article Type:Brief Article
Geographic Code:1USA
Date:Jul 1, 1997
Words:226
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