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Kansas Heart triggered a cascade. This quiet, airy city of 540,000 already had--besides Via Christi's hospitals--the Wesley Medical Center, part of the for-profit HCA chain. Wichita now has five doctor-owned hospitals as well, along with a dozen ASCs and at least 10 free-standing diagnostic imaging centers, eight of which have physician investors. (Via Christi has a share in four of them, as it does in one ASC and a specialty hospital.) "The fear that emergency rooms and cardiovascular programs would close at community hospitals," says Duick, "has not been borne out over seven...
...Heart Hospital opened in Wichita in 2001, Wesley's net revenues from its cardiovascular program plummeted from a notch above $18 million to roughly $2 million. In 2003 the Kansas Spine Hospital opened, and in a year Wesley's neurosurgery revenues dropped $8.8 million, to roughly $1 million. Via Christi cardiovascular surgeries declined from 4,334 in 1998 to an estimated 2,950 this year. In that period, its executives say, the number of nonsurgically treated cardiac patients--who, say, have heart failure--remained relatively steady, around...
Hospitals are fighting back in none-too-subtle ways. Some won't let an ASC physician-investor admit patients in their wards. And powerful health systems often use their leverage to lock physician-owned competitors out of preferred networks of insurers. Via Christi owns Kansas' largest managed-care plan; Wesley has an exclusive contract in Wichita with the state's leading insurer, Blue Cross and Blue Shield. "It's brutal competition," says David Laird, CEO of the Heart Hospital of Austin, which competes with the Texas nonprofit Seton Medical Center. "They act like they have a halo over their heads...
Such competition is fueling the arms race. Via Christi is counterattacking with a new neuromedicine service line. The weapons: a 64-slice CT scanner; and a brand-new $3.5 million CyberKnife, an X-ray gun that zaps tumors with pinpoint precision, housed in its own $1.5 million building. It has set up a stroke-treatment center and brain-aneurysm lab. "This is one of the areas that we've beefed up since all the specialty stuff happened," says Larry Schumacher, CEO of Via Christi's Wichita operations. "We're trying very hard to protect that." Wesley, for its part...
...spend on their patients' well-being, but, HSC researcher Dr. Hoangmai Pham notes, it still rewards them far more generously for procedures than for cognitive services like diagnosis and management of disease. So Wichita, which 15 years ago had seven psychiatric inpatient facilities, now has one, run by Via Christi. It has six that do heart surgeries...