Impact of the Current United States Health Care Environment on Practice

McClelland, Walter B.; McCollam, Stephen M.

doi:10.1016/j.hcl.2020.01.015

Cited by 4 publications

(5 citation statements)

References 4 publications

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“…After review of the full text, 89 articles were excluded for such reasons as description of a qualitative (instead of quantitative) analysis, 7,26,29,33 evaluations of post-acquisition considerations, [34][35][36][37][38][39] and a narrow focus on governmental regulations. [40][41][42][43][44] Twenty-six (26) articles remained for inclusion into the systematic review, and their resultant characteristics are located in Figure 2, including type of analysis, specialty analyzed, and years of data reviewed. Fifteen of these articles analyzed physician consolidation, or the change in number of physicians and distinct number of practices in a given specialty.…”

Section: Resultsmentioning

confidence: 99%

The Risks and Benefits of Physician Practice Acquisition and Consolidation: A Narrative Review of Peer-Reviewed Publications Between 2009 and 2022 in the United States

Tewfik,

Grech,

Laham

et al. 2024

JMDH

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The objective of this narrative review was to assess current literature regarding acquisition and consolidation of physician practices in the United States (US). The acquisition and consolidation of physician practices is a trend affecting patient care, quality of services, healthcare economics and the daily practice of physicians. As practices are acquired by fellow physician groups, private equity investors and entities such as hospitals or large healthcare systems, it is important to better understand the underlying forces driving these transactions and their effects. This is a narrative review of peer-reviewed publications to determine what current literature has covered regarding the acquisition and consolidation of physician practices in the US regarding risks and benefits of this trend. Sources included the SCOPUS, Medline- PUBMED and Web of Science databases. Peer reviewed publications from 2009 to 2022 were included for initial review and curation for relevance using the search terms “physician” and “practice” with either “acquisition” or “consolidation”. Synthesis conducted after narrowing down of relevant articles did not use quantitative measurements, but instead examined overall trends, as well as risk and benefits of ongoing acquisition and consolidation in a narrative format. Journal articles focused on physician consolidation in the US often reported increases in physician numbers with decreases in numbers of individual practices. Private equity quantitative analyses reported rapidly accelerating acquisitions driven by these investors, and vertical integration scholarly work reported frequent geographic consolidation of nearby practitioners. Risks associated with these transactions included such items as decreased physician autonomy and higher cost of care. Benefits included practice stability, improved negotiation with insurers and improved access to resources.

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Section: Resultsmentioning

confidence: 99%

The Risks and Benefits of Physician Practice Acquisition and Consolidation: A Narrative Review of Peer-Reviewed Publications Between 2009 and 2022 in the United States

Tewfik,

Grech,

Laham

et al. 2024

JMDH

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“…17e20 This shift away from individual practice is a trend that has been observed across specialties and transcends most gender preferences that may exist, perhaps reflecting the evolving list of physician priorities and responsibilities. 10,21,22 Ultimately, these data provide a framework which urologists may wish to consider when starting practice. Although Medicare is but one of many payers for most practices, and may therefore not represent a majority contribution to the payer profile, most urology practices do depend on Medicare claims to some extent due to the patient population of this specialty.…”

Section: Discussionmentioning

confidence: 99%

“…9 Physicians choosing to practice independently shoulder the responsibility of delivering high-quality medical care while ensuring that the practice can meet increasingly complex and stringent standards. 10 Although these responsibilities can be outsourced, this could involve additional expenditures, potentially exacerbating health care spending. 9,11,12 With its heterogeneous population, the United States presents a multitude of opportunities in which certain practice models can be beneficial.…”

Section: Discussionmentioning

confidence: 99%

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Urologist Scores in the Era of the Merit-Based Incentive Payment System (MIPS)

2022

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Introduction:The shift from fee-for-service to value-based payment introduces a new set of challenges and opportunities for the practicing physician. It is unknown how urologists have been impacted by the recent implementation of the merit-based incentive payment system (MIPS). We describe the MIPS performance scores of urologists and investigate their association with practice patterns.Methods:Urologists were identified in the 2018 MIPS performance score database and classified by participation status: individual practice, group practice or alternative payment model (APM). The overall MIPS score is comprised of 4 categories: quality, promoting interoperability, cost and improvement activities. Comparative statistics were performed using Tukey’s honest significance test and chi-square analysis. Multinomial logistic regression was performed to test associations.Results:A total of 9,055 urologists were included with the following average scores: quality 82.5, promoting interoperability 88.9, cost 74.4, improvement activities 37.3 and overall 86.9. When stratified by participation status, urologists in group practices scored higher than individual urologists in each category except cost; urologists in APMs often scored even higher. Preference for group practice or APMs was more common among urologists who graduated medical school more recently. Geographic location also appears to be a contributing factor when evaluating practice type.Conclusions:Urologists who participated as a group practice or APM scored higher across most MIPS categories than those in an individual practice. Introduction of a new reimbursement schedule will likely result in further evolution of practice patterns in the future.

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“…Administrative fees, staff salaries, and overhead are all costs associated with starting a practice, and a steady volume of patients is required to maintain these expenses. 7 , 13 However, surgeons early in their career are often faced with competition from more experienced and distinguished senior surgeons who have already established a patient population, reputation in the community, and referral relationships with colleagues. Early-career surgeons who are potentially seeing fewer patients may also have more time to devote to building their social media presence.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Social Media and Online Utilization Among Members of the American Orthopaedic Society for Sports Medicine: Implications in Practice

Kerzner

Hodakowski

Fortier

et al. 2023

Orthopaedic Journal of Sports Medicine

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Background: Social media has the potential to act as an avenue for patient recruitment, patient and surgeon education, and expansion of the physician-patient relationship. Purpose: To evaluate the existing social media presence among members of the American Orthopaedic Society for Sports Medicine (AOSSM) to describe trends in different subgroups within the membership. Study Design: Cross-sectional study. Methods: The AOSSM database was queried for a complete membership list. Members were excluded from analysis if they were not orthopaedic sports medicine surgeons practicing in the United States. Demographic characteristics, online media profiles, and levels of online presence were evaluated, and an online media presence score was calculated. Bivariate analysis was performed to compare demographic variables and levels of online presence. Results: A total of 2870 surgeons were included in the analysis. LinkedIn was the most used platform (56%), while YouTube was the least used (10%). Surgeons in academic practice had a significantly greater overall social media presence than their private practice counterparts. Female surgeons had a more significant active online presence on Twitter, Instagram, and Facebook than male surgeons. Surgeons practicing in the Northeast had a greater social media presence than those in any other United States region, and surgeons in the earlier stages of practice (0-14 years) were more likely to utilize social media than their more senior colleagues (≥15 years of practice). On multivariate analysis, surgeons in the earlier stages of practice were more likely to have active Twitter, Instagram, and Facebook accounts, and female surgeons were more likely to have an active Facebook account. Additionally, multivariate analysis revealed that a greater number of ResearchGate publications were associated with male sex and having an academic practice. Comparatively, active Twitter and Instagram use was associated with having an academic practice. Conclusion: The most used platform in this surgeon population was LinkedIn. Orthopaedic surgeons in academic practice, female surgeons, those early in their career, and those practicing in the Northeast highlighted a subset of the sports medicine community who were more likely to have an active online presence compared to the rest of the AOSSM.

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Impact of the Current United States Health Care Environment on Practice

Cited by 4 publications

References 4 publications

The Risks and Benefits of Physician Practice Acquisition and Consolidation: A Narrative Review of Peer-Reviewed Publications Between 2009 and 2022 in the United States

The Risks and Benefits of Physician Practice Acquisition and Consolidation: A Narrative Review of Peer-Reviewed Publications Between 2009 and 2022 in the United States

Urologist Scores in the Era of the Merit-Based Incentive Payment System (MIPS)

Evaluation of Social Media and Online Utilization Among Members of the American Orthopaedic Society for Sports Medicine: Implications in Practice

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