Physician Ownership Linked to Higher Surgery Volume

Physicians invested in ambulatory surgery centers do twice as many procedures as non-invested peers
By Monica Smith
HealthDay Reporter

THURSDAY, April 8 (HealthDay News) -- Physicians with an ownership stake in an ambulatory surgery center (ASC) perform, on average, twice as many procedures as physicians without an ownership stake, according to research published in the April issue of Health Affairs.

John M. Hollingsworth, M.D., of the University of Michigan in Ann Arbor, and colleagues used the Healthcare Cost and Utilization Project's State Ambulatory Surgery Databases to analyze data from Florida from 2003 to 2005. They looked at all patients in Florida who underwent one of five common outpatient procedures: cataract excision, carpal tunnel release, knee arthroscopy, colonoscopy, and myringotomy with tympanostomy tube placement. They compared the number of surgeries performed among ASC owners before and after they acquired ownership with that of physicians who were non-owners.

The researchers found that owners performed, on average, twice as many procedures as non-owners. An owner performed, on average, 16 more carpal tunnel releases, 204 more cataract excisions, 366 more colonoscopies, 53 more knee arthroscopies, and 15 more myringotomies annually than a non-owner. Also, caseloads increased over the study period for all physicians, but the increases were more dramatic and rapid among owners.

"Our analysis revealed a significant association between physician-ownership and higher surgical volume. Possible remedies include revising federal law to require disclosure of investment arrangements; reducing facility payments to dilute ownership incentives; and reforms (such as accountable care organizations) that discourage an excessive rate of procedures," the authors write.

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