title: Physician-ownership of ambulatory surgery centers linked to higher volume of surgeries.
abstract: Many physicians confronting declining reimbursement from insurers have invested in ambulatory surgery centers, where they perform outpatient surgical and diagnostic procedures. An ownership stake entitles physicians to a share of the facility's profits from self-referrals. This arrangement can create a potential conflict of interest between physicians' financial incentives and patients' clinical needs. Our analysis of Florida data for five common procedures 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.
authors.affiliation: Robert Wood Johnson Foundation Clinical Scholar at University of Michigan in Ann Arbor, USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Hollingsworth
authors.forename: Zaojun
authors.initials: Z
authors.lastname: Ye
authors.forename: Seth A
authors.initials: SA
authors.lastname: Strope
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Krein
authors.forename: Ann T
authors.initials: AT
authors.lastname: Hollenbeck
authors.forename: Brent K
authors.initials: BK
authors.lastname: Hollenbeck
mesh_terms: D003953:Diagnosis-Related Groups; D005431:Florida; D013502:General Surgery; D006302:Health Services Research; D006801:Humans; D010067:Ownership; D018584:Physician Self-Referral / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000191:economics / Q000706:statistics & numerical data; D013531:Surgicenters / Q000706:statistics & numerical data*