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Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.

Clinicians Protest ICU Closure at Minnesota Hospital

In Minnesota, Allina Health plans to eliminate intensive care at their Unity Hospital campus and will transfer patients to their Mercy Hospital campus 9 miles away, the reported. The changes sparked a public dispute between Allina leadership and hospital staff, including recently unionized doctors, nurses, and other workers.

"Ambulance transfers between Unity and Mercy take hours, even when the patient status is critical," Gail Olson, a long-time nurse at the Unity campus, told the Star-Tribune. "Reducing Unity's ability to care for critically ill patients will make this worse."

Allina's leadership said that changes will reduce hospital overcrowding and emergency department backlogs, including the "boarding" of patients in the emergency department while waiting for inpatient beds. It will also reduce transfers and delays when patients needing intensive care can go straight to Mercy Hospital, leadership said.

According to one hospitalist, all hospitals have patients who deteriorate and need intensive care urgently. This could lead to more transfers, not fewer, and transfer times have crept up to 115 minutes on average this year. EMS leaders say their agencies are already short on paramedics and drivers, and increasing requests for transfers will have them stretched even more thinly.

Hospital Facility Fees for Outpatient Services

Facility fees are becoming the new normal for some routine outpatient care, according to the , as hospitals buy up clinics and medical groups. These fees raise patient costs by hundreds of dollars for colonoscopies, mammograms, and heart screening even if the patient was never admitted to a hospital.

Medicare advisers said the federal payer likely overpaid for a sample of services by $6 billion thanks to facility fees in 2021, according to the Journal.

Hospitals say they collect the fees to offset what it costs them to keep up with federal regulations, and that the extra revenue is needed in a market burdened with high labor costs and inflation. Some states have started to curb the fees by prohibiting them or requiring disclosure ahead of time. The House of Representatives, however, has passed a bill that would stop Medicare from covering certain facility fees.

Hospitals are also buying up oncology and cardiology practices, acquiring new specialists, and subsequently raising facility fees. In one example, Novant Health in North Carolina bought up a number of cancer clinics. After the acquisition, one of its clinics, Lake Normal Oncology, billed a breast cancer survivor and single mom around $400, up from $76, for monitoring.

Hospitals Eye Sports Performance Centers

Somewhere in between concierge medicine and physical therapy lies a new kind of business venture for hospitals: sports performance centers, according to a report from .

Take Mass General Brigham's Center for Sports Performance and Research, for instance. Situated next to Gillette Stadium, where the New England Patriots play, with a team of top trainers, it houses "technology under one roof that pro or collegiate teams might have," STAT reported.

Designed to enhance sports performance and prevent injury for people at any age and ability, the centers have forged high-profile relationships with hospitals -- which also allow for health systems to form alliances with professional sports teams like the Cleveland Cavaliers or the Houston Rockets.

Because these centers bill themselves as separate from sports medicine, their clients -- who range from the everyday pickleball payer to more serious athletes -- pay out of pocket, sometimes hundreds of dollars a week, according to STAT.

An array of technology to improve reaction time, peripheral vision, and hand-eye coordination is available, along with some less-proven techniques endorsed by pro athletes, like cryotherapy. A "potential treasure trove of data" collected by the centers for research has even led to participation in Department of Defense projects.

Proponents of the centers, like Dave Granito, director of injury prevention and recovery for Mass General's sports performance center, known as CSPaR, say they're filling a gap for patients who might have used physical therapy to recover from an injury but still aren't back at their peak performance. "I want to make happy, healthy people that move well and can succeed in life with our guidance and are not searching the internet for whatever they can do," he told STAT.

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