Nonprofit hospitals in North Carolina fear that if legislation allows for more multi specialty physician-led ambulatory surgery centers (ASCs) to open without needing prior approval from the state, these facilities will go on a cherry picking spree for private coverage patients. Should this happen, hospitals will be left to care for revenue-losing patients – those who are either uninsured or on Medicaid.

Hospitals frequently use the cherry picking argument to protect themselves from potential competition. If there’s no margin, there’s no mission. I get that. But the current deal community hospitals have with the feds is that in order to not pay property tax, sales tax, or income tax, they are required to care for any patient who walks through their doors, regardless of their ability to pay.

Legislators should dismiss this claim. Based on data from 2014 facility license renewal applications, payer mix is pretty comparable between existing multi-specialty physician-led ASCs and surgery centers partially or wholly owned by hospitals.



hospital payer mix