[sailor]

There are ways around Stark, like making the physicians debt-holders, instead of equity-holders. I’m not sure what ACA did, but you are making my point for me, since a direct-pay hospital would not accept Medicare or big health plans. Ambulatory surgery centers, like Surgery Center of Oklahoma are showing that direct-pay for outpatient surgery is often cheaper through their direct-pay surgeons than through major-medical plans. Acute-care hospital pricing shenanigans are making an increasing number of Americans willing to look for, and pay more for, predictable alternatives.