Innovation, Technology Can Help Physicians Stay Independent —Physicians Foundation

Alternatives to Hospital Employment Include Solo ‘Micropractices,’ Patient-Centered Medical Homes, and Direct-to-Pay Practices

Andy Robeznieks at Modern Physician reports that medical practice innovation—including the use of technology to increase efficiency and reduce overhead—is what “holds the key to private practice being a viable alternative to salaried employment,” according to a new report from the Physicians Foundation (PDF).

The 70-page report, titled The Future of Medical Practice: Creating Options for Practicing Physicians to Control Their Professional Destiny, was written by Jeff Goldsmith, associate professor of public health sciences at the University of Virginia, who was No. 77 on Modern Healthcare’s 100 Most Powerful People in Healthcare list in 2004.

Physicians seeking economic security have been turning to employment by hospitals and large medical systems, but Goldsmith cites an MGMA-ACMPE study that found that hospitals’ viability also is being threatened, as hospital losses per physician averaged $212,000 in 2010. The report suggests that other options to employment by hospitals are solo “micropractices,” patient-centered medical homes and direct-to-pay practices.

There is, however, a catch.

“Physicians’ willingness to organize to manage population health risk will be essential to regaining control over their professional lives,” Goldsmith wrote. “The alternative is to continue to have their clinical decisions micromanaged by health plans and Medicare.”

But because “the Affordable Care Act of 2010 virtually ignored the task of renovating and strengthening medical practice,” Goldsmith said, several policy changes are needed in order for physicians to be “active participants” in a new healthcare system.

Proposals made in the report include instituting a 30% increase in Medicare payment for evaluation and management services, eliminating “site of service” fees that allow hospitals to collect more for physician services, creating provider-sponsored health plans and providing debt relief for physicians in exchange for receiving lower fees from Medicare.

“Medical practice as an institution urgently needs modernization and renovation if it is to have a noninstitutional component,” Goldsmith concluded.

The foundation was founded in 2003 by 20 state and regional medical societies and funded through a class-action lawsuit settlement against private third-party payers. Since 2005, it has provided more than $28 million in grants for projects and research seeking to help physicians “provide better, safer and higher quality medical care.”

 

 

Many Physicians Would Like to Remain Independent.  A New Physicians Foundation Report Offers Tips on How.