Summa Health System and the Crystal Clinic are taking a big step today toward bringing a $100 million specialty hospital for bone, joint and muscle problems to Akron.

Construction of a state-of-the-art hospital to be known as the Crystal Clinic Orthopaedic Center kicks off this evening with a ceremonial groundbreaking on Summa's Akron City Hospital campus.

The five-story facility on Adolph Street between East Market and Forge streets is expected to open by fall 2010.

''It's going to be an offering that's unsurpassed in the region,'' said Thomas J. Strauss, Summa's president and chief executive. ''We believe what heart is to Cleveland, orthopedics is and will be to Akron, Ohio.''

The new specialty hospital is part of Summa's plan to fuse its orthopedic services with the Crystal Clinic, a specialty practice with about 30 doctors.

By the end of the year, the health system and physician group expect to jointly own and operate Summa's existing inpatient orthopedics program at St. Thomas Hospital and the Crystal Clinic's outpatient surgery center in Bath Township.

The new orthopedic hospital also will be a 50-50 venture between Summa and the doctors, with both sharing equally in costs and revenues.

The project shows ''a partnering of doctors and hospitals working together — instead of competing like they do at most places — to maximize quality,'' said Dr. Scott Weiner, head of Summa's orthopedic department.

The Crystal Clinic had been exploring options for building its own orthopedic hospital — possibly in Montrose or Hudson — when the doctors instead opted to partner with Summa and keep inpatient services in Akron, said Dr. T.J. Reilly, the Crystal Clinic's president.

By working together, he said, Summa and the doctors can enhance patient care, remain committed to educating future doctors, recruit more specialists to the region and lower costs by avoiding duplication.

Nationwide, hospitals increasingly are teaming up with doctors for joint ventures, including shared ownership in new facilities, said Debra Draper, associate director for the Center for Studying Health System Change, a national health-care research group.

Locally, Summa also is pursuing plans to construct a 100-bed community hospital in northern Summit County off state Route 8 in partnership with area doctors.

''It's a way that they're more closely aligned with physicians,'' Draper said. ''In some ways, it's a defensive strategy by the hospitals to prevent the physicians from creating their own ambulatory surgery centers and their own hospitals.''

The results can be mixed for consumers, Draper said.

Hospitals with higher volume for specific procedures can improve quality and potentially lower costs because of fewer complications, Draper said.

But on the flip side, she said, consolidation can drive up health-care costs by giving the hospital more clout to negotiate higher payments from insurers.

The merger between the for-profit Crystal Clinic and the nonprofit Summa orthopedic program will require a review by the Ohio Attorney General.

In recent years, the federal government has been more closely scrutinizing doctor-owned hospitals, many of which focus on profitable services, such as cardiac, orthopedic and other surgeries.

A study published this month in the professional journal Medical Care suggests that doctors with stakes in a specialty hospital ordered more tests, surgeries and other services for injured workers with back or spine disorders than doctors without an ownership interest.

Molly Sandvig, executive director of the Physician Hospitals of America, which represents hospitals nationwide that are partially or wholly owned by doctors, dismissed the criticism. She argues that doctors would face legal problems and lose their licenses if they inappropriately ordered tests or procedures.

She estimates there are about 200 physician-owned hospitals nationwide, with another 40 under development.

On average, doctors who have an ownership stake in a hospital make about $70 per procedure at the facility, in addition to the professional fees they charge, Sandvig said.

''To me,'' she said, ''the biggest advantage of a physician-owned hospital is the physician actually regains control of the care of the patients.''

Reilly said the Crystal Clinic already has a good track record of keeping costs in line at its physician-owned outpatient surgery center, as evidenced by the fact that most major insurers contract with the facility.

Akron's new orthopedic hospital will include a clinic for uninsured patients, Reilly said.

The Crystal Clinic's outpatient surgery center also will begin accepting low-income patients covered by the state-run Medicaid program after the merger with Summa, he said.

''It increases the access to the highest-quality orthopedic care for all patients with orthopedic problems, regardless of the ability to pay,'' Reilly said.

The Crystal Clinic Orthopaedic Center will feature 12 operating rooms and 96 private inpatients rooms, an increase from 65 at Summa's current space at St. Thomas Hospital.

Summa also plans to expand its emergency department at Akron City Hospital, in part to accommodate the orthopedic emergencies that will be referred there when the new specialty hospital opens in two years, Strauss said.

Summa officials still are determining what services will be housed at St. Thomas after orthopedics relocates, but inpatient behavioral health services will remain, Strauss said.