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Hospitals Rush to Employ Physicians to Shore Up Referrals, Admissions; Improved Care Coordination Takes a Back Seat to Hospitals’ Push for Market Share

August 22, 2011 Comments off

Hospitals Rush to Employ Physicians to Shore Up Referrals, Admissions; Improved Care Coordination Takes a Back Seat to Hospitals’ Push for Market Share
Source: Center for Studying Health System Change

While not new, the pace of hospital employment of physicians has quickened in many communities, driven largely by hospitals’ quest to increase market share and revenue, according to a study released today by the Center for Studying Health System Change (HSC).

To date, hospitals’ primary motivation for employing physicians has been to gain market share, typically through lucrative service-line strategies encouraged by a fee-for-service payment system that rewards volume, according to the study. At the same time, stagnant reimbursement rates, coupled with the rising costs of private practice, and a desire for a better work-life balance have contributed to physician interest in hospital employment.

While greater physician alignment with hospitals may improve quality through better clinical integration and care coordination, hospital employment of physicians does not guarantee clinical integration, according to the study. The trend of hospital-employed physicians also may increase costs through higher hospital and physician commercial insurance payment rates and hospital pressure on employed physicians to order more expensive care.

+ Rising Hospital Employment of Physicians: Better Quality, Higher Costs?

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Physician Practices, E-Prescribing and Accessing Information to Improve Prescribing Decisions

May 7, 2011 Comments off

Physician Practices, E-Prescribing and Accessing Information to Improve Prescribing Decisions
Source: Center for Studying Health System Change

Hoping to reduce medication errors and contain health care costs, policy makers are promoting electronic prescribing through Medicare and Medicaid financial incentives. Many e-prescribing systems provide electronic access to important information—for example, medications prescribed by physicians in other practices, patient formularies and generic alternatives—when physicians are deciding what medications to prescribe. However, physician practices with e-prescribing face challenges using these features effectively, according to a new qualitative study by the Center for Studying Health System Change (HSC) funded by the Agency for Healthcare Research and Quality (AHRQ).

Primary Care Physician (PCP) Supply and Health Reform Medicaid Expansions

April 21, 2011 Comments off

Primary Care Physician (PCP) Supply and Health Reform Medicaid Expansions
Source: Center for Studying Health System Change

In much of the country, growth in Medicaid enrollment under health reform will greatly outpace growth in the number of primary care physicians willing to treat new Medicaid patients, according to a national study released today by the Center for Studying Health System Change (HSC).

And, temporary increases in Medicaid reimbursement meant to entice more primary care physicians into accepting Medicaid patients are unlikely to make much of a difference in the states facing the biggest enrollment jumps, according to the study funded by the Robert Wood Johnson Foundation (RWJF).

Under federal health reform, Medicaid eligibility will expand to cover as many as 16 million more poor and low-income adults by 2019. Nationally, 42 percent of primary care physicians in 2008 were accepting all or most new Medicaid patients, compared with 61 percent of PCPs accepting all or most new Medicare patients and 84 percent accepting all or most privately insured patients. Given the unwillingness of many PCPs to treat new Medicaid patients, policy makers and others are concerned about adequate primary care capacity to meet the increased demand from new Medicaid patients.

The study found that states with the smallest number of primary care physicians per capita overall—generally in the South and Mountain West—potentially will see the largest percentage increases in Medicaid enrollment. In contrast, states with the largest number of PCPs per capita—primarily in the Northeast—will see more modest increases in Medicaid enrollment.

The law also increases Medicaid reimbursement rates for certain services provided by primary care physicians to 100 percent of Medicare rates in 2013 and 2014. The reimbursement increases will have much less impact in states with a relatively small number of PCPs accepting Medicaid patients now because many of these states already reimburse primary care at rates close to or exceeding 100 percent of Medicare.

+ Full Report (PDF)

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