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For more than three decades, Congress has struggled with potential financial conflicts of interest when physicians share in financial gain from nonprofessional services. This study asks the question: Are physicians who are leading referrers to physician-owned ambulatory surgery centers (ASCs) more likely to send Medicaid patients to hospital outpatient clinics than other patients? The comparison group is physicians who are leading referrers to non-physician-owned ASCs, using data from two metropolitan areas. Findings indicate that physicians at physician-owned facilities are more likely than other physicians to refer well-insured patients to their facilities and route Medicaid patients to hospital outpatient clinics. [Health Affairs 27, no.
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