Tuesday, January 11, 2011

10 Key Trends for Hospitals in 2011

Becker's Hospital Review has posted 10 trends for hospitals in the coming year. They received their information from 2 hospital CEOs, 3 association executives, and 2 consultants.

Here is what they came up with:

1. Lower Reimbursements
2. RACs gather momentum
3. More uncompensated care
4. Political gridlock
5. Uncertain fate of Healthcare Reform
6. Anticipated ACO rules may open the floodgates
7. Greater focus on experimentation
8. States will further cut Medicaid spending
9. Healthcare IT payments start
10. More hospital consolidation likely

Read the full article in Becker's Hospital Review, or click here:
http://www.beckershospitalreview.com/hospital-financial-and-business-news/10-key-trends-for-hospitals-in-2011.html

Thursday, January 6, 2011

2011: Evolution of the Private Practice

We are hearing constant reports of the death of the private practice so we found it refreshing to read this article from Physicians Practice about the evolution of the private practice.

Although the current healthcare climate is forcing changes to today's and even yesterday's typical private practice model, the private practice will always be an alternative for entrepreneurial physicians who want to control their own practice. According to the article although healthcare economics have changed, federal regulations now impact office operations, and the workforce has dramatically changed, there is still and will always be a need for private practices and a profitable way to run them; particularly for larger single or multi-specialty practices that can afford professional management and have diversified their services (such as through ancillary services) so that they can benefit from revenue that does not require physician effort.

Key factors for the survival of private practices in the future are implementation of new technology and EMR, operating under lower overhead, and hiring adequate support staff (both administrative as well as medical). The stereotype for private practices is that these physicians work longer hours and have little to no vacation; while this might still prove to be true in today's private practice physicians can still control their practice and income while having a good quality of life with adequate support from partners and PAs/NPs.

Although a lot of hospitals will be acquiring groups and employing physicians, private practices can still negotiate different types of terms and models with hospitals while still maintaining control of their practice.

According to the article, if physicians are able to accept new ways to run a private practice than private practices will survive any healthcare and economic climate.


Read the full article in Physicians Practice, or click here:
http://www.physicianspractice.com/pearls/content/article/1462168/1752472

Monday, January 3, 2011

2011: The Current State of Physician Integration

With the cuts in Medicare reimbursement and the unknown status of healthcare reform, many physicians and hospitals are coming up with new ways to form employment relationships and work together.


Hospital Employment has been a trend we have previously discussed, but there are also many alternative ways hospitals and physicians can work together to create a mutually beneficial model that makes sense for both parties financially. Hospitals are being more creative in ways to maintain and develop relationships with their physicians. Many are embracing a variety of strategies, such as employing physicians and acquiring group practices, creating co-management roles for physicians and giving them greater say in governance of the organization.


A recent PricewaterhouseCoopers survey found that 44% of physicians are already employed by some entity, from hospitals to group practices, and 46% are interested in pursuing this model in the next two years. Hospital employment provides a guaranteed salary for a physician and the physician can focus on caring for patients instead of running a practice and worrying about payment and reimbursements. Hospital employment can cover lower reimbursements and also integration and new administrative requirements physician practices are subject to, such as installing electronic medical records.


The PricewaterhouseCoopers survey found that physicians practicing in large groups are 2-3 times more likely to express interest in hospital alignment than solo practitioners.


Hospitals have also implemented Management Services Organizations. The hospital and practices share expenses for functions such as purchasing supplies, practice management services, and some aspects of managed care contracting and electronic health records.
Another model that has been explored and implemented is a Co-Management Arrangement. In a co-management arrangement, a physician or group of physicians is paid to carry out management work for the hospital. The physicians are paid for the cases they handle, but responsibilities can also include administrative tasks like writing up protocols for establishing a physician-integration model.


Co-management and similar payment arrangements are catching on as alternatives to employment. The PricewaterhouseCoopers survey found that 24% of physicians are currently aligned in this model and 51% of physicians are interested in pursuing it over the next two years.
Another model that has been explored is a Governance Model. In a Governance model, the hospital has set up an internal physician committee made up of physicians. The physician members participate in hospital decision-making separate from the hospital medical staff and serve as a joint operating committee.


Hospitals and physicians need to keep an open mind in this quickly changing medical and health care climate. Hospitals need to be flexible and open to different options to attract the best physician candidates and maintain the best quality of care for their patients.


Read the full article at Becker’s Hospital Review or click here:http://www.beckershospitalreview.com/hospital-physician-relationships/physician-employment-a-beyond-the-current-state-of-physician-integration.html

Monday, December 13, 2010

Higher Compensation in Less Competitive Markets

The Center for Studying Health System Change has completed a study on the average compensation for physicians in different marketplaces and geographic locations. The study found that Physicians and Hospitals in some markets can drive payment levels far above those paid in more competitive markets (larger metropolitan areas).

This study referenced that physician's actual compensation was less variable in different markets, however hospitals were paid nearly five times the Medicare rate for inpatient care and more than seven times the rate for outpatient care in some of the most extreme areas the study found.

Read the full article in American Medical News, or click here:

http://www.ama-assn.org/amednews/2010/12/06/bisc1210.htm

Physicians Opting out of Private Practice Because of Uncertainty

The Physicians Foundation has conducted a survey on physician's changing practice models. Concern about how health system reform and continuing instability in Medicare pay have an increasing number of physicians pondering changes in how they practice.

Many physicians are considering cutting back on hours, switching to concierge medicine, taking locum tenens positions or selling their practices to accept hospital jobs, according to the survey released November 19th.

Read the full article in American Medical News, or click here:
http://www.ama-assn.org/amednews/2010/12/13/bisc1213.htm

Wednesday, December 8, 2010

Physician Background Check: What Physicians Need to Know

All of the facilities, private practices, and academic institutions we work with require a background check to be completed on the candidate, usually prior to an offer being made. The New England Journal of Medicine has provided a good article on what a physician needs to know about the process of a third party obtaining a background check.

Although this article suggests some physicians need to complete a background check prior to the interview, we find it more common to complete a background and malpractice screen once the offer process has began typically after the first or second site visit. Either way, the background process is common and is not something a candidate should be overly concerned about.

Read the full article at http://www.nejmjobs.org/career-resources/physician-background-check.aspx

Tuesday, November 30, 2010

Physician Recruitment Today

This has been an interesting few years for physician recruitment. Of course we are constantly hearing of the physician shortage, but with the current economy and health care reform it has added a complicated factor in to recruiting physicians today.

The New England Journal of Medicine has published an article referencing 3 key findings to recruit and retain physicians.

To summarize the recommendations of the article, the NEJM suggests these 3 points to recruit and retain physicians:
  • Offer compensation models competitive to today's physician: take in to consideration competitive compensation but also other factors that entice physicians such as quality of life, shared call, paid CMEs and malpractice, bonuses, etc.
  • Offer leadership and/ or ownership potential
  • Be competitive in offers regardless of the economic situation

The current physician shortage across not only primary care but all specialties will only increase. Retaining and recruiting physicians will become more competitive than ever, top candidates will be more enticed with competitive offers than they are today. However, as the needs of physicians change, hospital groups, private practices, and even academic facilities need to evolve to attract physicians in a changing marketplace with new employment preferences.

Read the full article in the New England Journal of Medicine, or click here:
http://www.nejmjobs.org/rpt/intentional-retention-starts-with-recruitment.aspx

Tuesday, November 23, 2010

Check List: Job Offer Incentives for Physician Candidates

During the negotiation process there are many factors to consider outside of salary/ compensation alone. There are many other considerations physicians can leverage during contract negotiations.

We found a good check-list from Med Center today; although this article is geared toward academic physicians, the same considerations can be applied to candidates considering hospital employed and even private practice opportunities.

Here are some suggestions the article recommends to discuss during employment contract negotiations:
  • Moving Expenses
  • Sign-on Bonuses
  • Guaranteed minimum salary
  • Contract terms
  • Loan re-payment assistance
  • Relocation Assistance

Many of the other suggestions are geared specifically towards physicians seeking careers with academic facilities. However candidates seeking all models of employment can also negotiate call, paid time off, paid expenses (licensing, training, CME, etc.), and many other factors outside of compensation contributing to the physician's total quality of life.

Read the full article in Med Center Today, or click here:

http://www.medcentertoday.com/checklist.php?id=66

Tuesday, November 16, 2010

Physician Employment: Leveraging Benefits with Hospitals

Hospitals have become very creative and flexible on how they are able to attract new physicians and also consider merging with current physician groups. If physicians are able to negotiate during the offer process they are often able to get the practice set-up and other benefits they want.

Not only are physicians able to negotiate for hospital employed positions, but hospitals can also be flexible with joint ventures, non-profit physician networks, and making EMS and other software available to community physicians at a discounted rate.

Other terms physicians can negotiate, particularly for hospital employment opportunities, are flexible schedules and workloads, benefits, paid CMEs and other continued training, vacation and paid time off, and call schedules.

Read the full article in American Medical News, or click here:
http://www.ama-assn.org/amednews/2010/11/15/bisa1115.htm

Monday, November 1, 2010

MGMA Annual Conference: Outlook Pending Healthcare Reform

The Medical Group Management Association has had their annual conference in New Orleans. Many of the speakers indicated healthcare reform has left a pending synopsis of the state of healthcare.

Throughout this year healthcare providers have seen many changes to current regulations as well as new implementations. Exactly what will happen when healthcare reform takes place is also undetermined.

According to speakers at the conference, there are 3 payment models to watch:

• Accountable care organizations

• Bundling of payments

• Value-based payment modifiers

Many sessions focused on general reform objectives – how to control spending, improve access, create incentives and enhance quality.

Read the full article at Healthcare Finance News, or click here: http://www.healthcarefinancenews.com/news/mgmas-outlook-still-waiting-reform