What happens when physicians sell their practices

Source: https://www.beckersasc.com/asc-transactions-and-valuation-issues/what-happens-when-physicians-sell-their-practices.html

Physician practices are selling to hospitals and corporate entities at an accelerated rate during the COVID-19 pandemic.

But what happens to healthcare when there is increased consolidation and less competition? Several studies over the past decade have examined these trends. Six notes:

1. The cost of care increases. The most concentrated healthcare markets where physicians are part of health systems charge fees 14 percent to 30 percent higher than in the least concentrated markets, according to a study published in The Journal of Law & Economics. Physician costs in highly concentrated markets were also higher than physicians practicing in the least concentrated markets.

2. The price of health insurance increases. In California, premium prices were up 12 percent in markets where there was a higher share of physicians employed by hospitals, according to a study in Health Affairs. Hospitals that don't have competitors within 15 miles charge on average 12 percent more than hospitals with four or more competitors, according to data from the National Bureau of Economic Research.

3. Outpatient services prices increase when hospitals acquire physician practices, according to a study published in JAMA Internal Medicine. Hospital outpatient departments are also able to charge Medicare more for the same services as ASCs, although patient deductible is lower for some services.

4. The quality of care suffers. Medicare beneficiaries are more likely to choose high-cost, low-quality hospital care when physicians are employed at the hospital, according to a study in the Journal of Health Economics.

5. Patients are less satisfied. A study published in Health Services Research found patients were more satisfied in markets with less hospital consolidation.

6. Physician income drops. Independent physicians earn an average of 0.8 percent more than physicians in hospital-owned practices, according to an article in Health Affairs. The study also found a $2,987 drop in income for physicians overall after their practice is acquired. Medscape also reports independent physicians earn more than employed physicians and specialists, including orthopedic surgeons. The independent orthopedists made $29,000 more than employed orthopedists in 2021.

Telehealth from the Field: Case Study Involving Remote Monitoring Problems

Sue Boisvert, BSN, MHSA, Patient Safety Risk Manager II, The Doctors Company, and Chad Anguilm, MBA, Vice President, In-Practice Technology Services, Medical Advantage, Part of the TDC Group of Companies

Even before the COVID-19 pandemic, the use of remote patient monitoring was expanding. The technologies offer many benefits, but they may also create potential malpractice risks. Consider the following case example and strategies that can help mitigate risks.

Case Example

During an annual physical, the physician recommended ambulatory electrocardiography for a patient with a history of prior cardiac arrhythmia. The physician told the patient he would receive the ambulatory monitor by mail and that the package would contain everything he needed.

About a week later, the monitoring package arrived. opened it, read the instructions, and applied the device. After a few hours, the device fell off. He reapplied it multiple times, but the device continued to fall off. After several calls with the device manufacturer, the patient gave up, tucked the device in the box, and mailed it back to the manufacturer.

A week later, the patient received a letter from the physician, stating that his monitoring results were normal. The patient—who was surprised to receive these results—followed up. During the discussion, the physician told him that the device manufacturer downloaded and evaluated the results and provided a report that the physician then shared with the patient. The physician was surprised to learn that the patient had not completed the monitoring period and the device had not performed as expected, but the results were still reported as normal. The patient lost confidence in both the physician and remote monitoring technology and did not return to the practice.

Patient Safety Strategies

Whether you have already implemented remote patient monitoring or are thinking about it, consider the following strategies:

• Use a deliberate process to evaluate and select remote patient monitoring devices.

• Determine how the data will be collected, transmitted, stored and reported. In the case example, the manufacturer reported the study as normal even thought the full monitoring period was not completed.

• Ensure the patient is ready to participate. Advise patients to call the office about any device problems or concerns. In the case scenario, the device did not adhere properly to the patient’s skin.

Plan and Prepare

This case study highlights the importance of careful planning and preparation when incorporating remote technologies into the patient care services offered by a medical practice. Providers who recommend products and services to their patients have a responsibility to apply due diligence in confirming that the device manufacturer is reputable, the device is safe, and the information it produces is accurate and reliable. Once a decision is made to use remote technology, the next steps should be to develop appropriate use guidelines that include preparing patients, managing device concerns/troubleshooting, tracking results, and following up with patients. 

2019 Novel Coronavirus and Patient Safety in the Medical Office

Debbie Hill, MBA, RN, Senior Patient Safety Risk Manager, The Doctors Company

The 2019 novel coronavirus (COVID-19) continues to spread across multiple continents, infecting tens of thousands of individuals worldwide, with thousands of deaths. On Tuesday, February 25th, the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, urged the U.S. public to begin making preparations for the possibility of a U.S. pandemic with “the expectation that this could be bad.” Given that outbreaks are expected to occur at a community level, medical offices will undoubtedly experience an influx of patients seeking assistance. The question is: Are medical offices doing enough to prepare?

Read More

Real Estate: The Second-Highest Expense in Your Practice

Orlando Medical News

When it comes to managing expenses in your practice, there are dozens of categories to evaluate: equipment, technology, loan costs and interest rates, sundries, marketing and on and on they go.

Many practice owners are quick to shop-out what they believe are the most obvious expenses, but few understand the impact of one of the largest expenses and how it can be dramatically reduced to increase profitability. The highest expense for most practices is payroll, followed by real estate. Real estate encompasses your monthly rent or mortgage payments, along with the property’s operating expenses, maintenance fees, utilities, and janitorial costs.  Read More

Tackling Physician Burnout Requires Unprecedented Leadership

By Robert D. Morton, CPHRM, CPPS, Assistant Vice President, Department of Patient Safety and Risk Management, The Doctors Company