The Attack on Ancillary Service Providers at the Federal and State Level

The health care delivery system in the United States has witnessed more dramatic changes during the last decade than it had since the passage of Medicare. The managed care revolution and changes in reimbursement for Medicare services have forced providers to look for more efficient ways to provide services as well as for additional sources of revenue- and margin-producing business. The move toward specialized inpatient and outpatient facilities, often owned by physicians, is a natural reaction to these significant changes. These developments have resulted a “turf war” between physicians and hospitals over who should control these revenues.