Primary care physicians (PCP) have been identified as a critical part of the future health care value chain. Yet, we know we have far too few of them. We also know that independent providers are struggling financially. As a result, a large number of primary care docs, perhaps a majority, have chosen to become employees of larger health systems. Most physicians label ‘salary’ as the top reason for becoming an employed clinician rather than trying to compete as an independent practitioner. But, with a CPT driven foundation for reimbursement, can this marriage between primary care and large health system be a healthy one?
When a PCP joins a health system and begins to receive a regular salary, the payments are often above that physician’s prior experiences in private practice, perhaps higher than could be reasonably calculated from the their daily productivity. CFO’s are willing to accept the scenario of primary care salaries exceeding productivity, because they are keenly aware that the primary care physician acts as a feeder for the more lucrative profit centers at the hospital. Specialists and their ancillary staff perform most of the profit generating procedures, imaging studies, pathology examinations. These high priced resources need patients (and their insurance cards) to generate the margin-rich revenue for the financial viability of the health system.
Continue reading “Primary Care Physicians are the New Backbone for Health Care. Has the Time Come to Abandon the CPT Code?”
First published 3/21/11 on Health Populi
The good news that was packaged in the Patient Protection and Affordable Care Act (PPACA), that is, health reform, was that millions of uninsured Americans would receive health insurance coverage through the Medicaid program. But insurance doesn’t equal access; there’s a limiting factor that’s a formidable obstacle in many of these millions of newly-insured people getting care: the physician supply in the U.S., which varies from region to region of the U.S.
Continue reading “Where Have All The Doctors Gone? What Physician Supply Means For Health Reform”
Originally published 10/27/2010 on The Doctor Weighs In
No, I am not blogging on veterinary topics now. Hamster medicine refers to the current practice of primary care in America. The term was used today by Elliott Fisher – one of the fathers of the Accountable Care Organization (ACO) movement – at the big ACO Conference held in LA [10/25-27, 2010]. ACOs, by the way, are the hottest thing in the health care industry to date. Everyone wants to have one, build one, buy one, consult to one or in some other way be affiliated with one – hopefully for the purpose of making money or growing/preserving your share of the lucrative health care market – and, by the way, perhaps improving care along the way.
Continue reading “Hamster Medicine”