Most physi­cians have given up on own­ing a prac­tice for join­ing larger net­works

Modern Healthcare - - NEWS - By Alex Kacik

A shrink­ing per­cent­age of physi­cians now own their own med­i­cal prac­tice, ac­cord­ing to new data from the Amer­i­can Med­i­cal As­so­ci­a­tion.

The share of physi­cians with own­er­ship stakes in a med­i­cal prac­tice de­clined to 47.1% in 2016 from 53.2% in 2012, the AMA found, mark­ing the first time that the ma­jor­ity of physi­cians were not prac­tice own­ers. Doc­tors, driven par­tic­u­larly by the younger de­mo­graphic, have been shift­ing from own­ing their own prac­tices to join­ing larger prac­tices, re­search shows.

Health sys­tems have been ag­gres­sively ac­quir­ing physi­cian prac­tices as they aim to bet­ter align physi­cian net­works to re­duce med­i­cal vari­a­tion, im­prove out­comes and sat­isfy pay­ment re­forms that re­quire broader pop­u­la­tions to re­main healthy.

Yet, that trend has seem­ingly stalled, ac­cord­ing to AMA data. The per­cent­age of physi­cians in hos­pi­tal-owned prac­tices or who were em­ployed di­rectly by a hos­pi­tal was the same in 2016 as in 2014 at 32.8%, but higher than 2012’s 29%. In 2016, 21% of doc­tors in hos­pi­tal-owned prac­tices said their prac­tice had been ac­quired by a hos­pi­tal in the past five years com­pared with 26.9% in 2012.

Con­sul­tants at­trib­uted the slow­down to hos­pi­tals hav­ing “as many prac­tices as they can han­dle at this point,” said the study, writ­ten by AMA Se­nior Econ­o­mist Carol K. Kane.

“Physi­cian com­pen­sa­tion is one of the fastest-grow­ing ex­penses in health sys­tems,” said Joel French, CEO of SCI Solutions, which of­fers web-based ac­cess man­age­ment prod­ucts that con­nect pa­tients, re­fer­ring physi­cians and hos­pi­tals. It has be­come as high as 10% of to­tal ex­penses for some sys­tems, he added. “The bur­den is not sus­tain­able.”

Hos­pi­tal own­er­ship is more preva­lent in mul­ti­spe­cialty prac­tices that in­clude pri­mary-care physi­cians, re­search shows. In 2016, 45.7% of mul­ti­spe­cialty prac­tices that in­cluded pri­mary-care providers were owned by hos­pi­tals com­pared with 33.3% that did not have pri­mary-care doc­tors. Nearly 14% of mul­ti­spe­cialty clin­ics were wholly owned by a not-for-profit foun­da­tion, the study found.

While most doc­tors de­liver care in smaller prac­tices of 10 or fewer physi­cians, the data points to a grad­ual shift to­ward larger prac­tices. In 2016, 13.8% of physi­cians were work­ing in prac­tices with 50 or more doc­tors com­pared with 12.2% in 2012.

The AMA’s Physi­cian Prac­tice Bench- mark Sur­veys were per­formed in 2012, 2014 and 2016 and in­cluded 95,262 physi­cians from across the coun­try who pro­vide at least 20 hours of pa­tient care per week.

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