MSSNY eNews: April 20, 2022
Majority of U.S. Physicians Employed by Health Systems or Corporate Entities
Nearly three quarters of U.S. physicians (74%) are employed by hospitals, health systems or corporate entities as of January 1, 2022, according to new data from Avalere, in a study sponsored by the Physicians Advocacy Institute (PAI) that examined physician practice trends over the three-year period between 2019 and 2021. This is an increase from 69% of U.S. physicians being employed just last year.
Health systems and corporate entities have been steadily acquiring physician practices for years, but Avalere researchers found the trend has accelerated drastically since the onset of COVID-19. More than one hundred thousand (108,700) physicians became employees since January 2019. Of those, 83,000 (76%) became employees since the pandemic began.
Corporate entities such as private equity firms and health insurers are driving the spike in these trends. Corporate purchases of practices increased by 86% during the study period, and corporate employment of physicians increased by 43%. In 2021, corporate entities acquired 13,600 additional physician practices.
In comparison, hospital, and health system purchases of practices (9%) and employment of physicians (11%) continued at steadier rates.
Avalere used the IQVIA OneKey database that contains physician and practice location information on hospital/health system ownership. These data include solo and single-location small practices as well as large, multi-specialty, multi-location group practices. These data include biannual physician and practice information. Researchers studied the three-year period from January 1, 2019 to January 1, 2022. Full methodology is available in the analysis.
CMS Announces Opening of Surprise Bill Resolution Portal
The Centers for Medicare and Medicaid Services (CMS) has announced the opening of the Independent Dispute Resolution (IDR) portal Home (cms.gov) which allows physicians to initiate the IDR process under the No Surprises Act for claims that cannot be brought to the State IDR process (for example, if the patient is covered through a self-insured employer health plan). According to a notice from the AMA, for those claims for which the open negotiations period expired prior to the portal opening, physicians have until May 6th to initiate the IDR process. For claims currently in the open negotiations period, the standard timelines will apply (i.e. the IDR process must be initiated within 4 business days of the open negotiations period ending). The IDR portal can be accessed here.
MSSNY’s Tip of the Week: Understanding Medicaid Billing
What can be done regarding Medicaid billing and private pay? MSSNY’s Heather Lopez is often asked this question, so she created a document for MSSNY members that provides all the information in one place. Click on this link to get the most up-to-date information regarding billing Medicaid and what to do if you do not accept Medicaid but your patient still wants to receive your services.
If you have questions about this or any other insurance concern, contact MSSNY’s Director of Physician Payment and Practice, Heather Lopez, at 518.465.8085 X332 | email@example.com
Racial and Health Equity: Five Concrete Steps for Health Systems
Dr. Rishi Manchanda, President and CEO of HealthBegins, walks listeners through the 5 steps health care leaders can take to start translating their commitment to racial and health equity into action. Listen on Apple Podcasts or Spotify.
Helping Private Practices Navigate Non-Essential Care During COVID-19
The American Medical Association has released updated guidance for private practice physicians navigating the provision of care during the COVID-19 pandemic. The resource emphasizes ways physicians and practices should protect their employees, patients, and visitors while also operating within the constraints of a national healthcare staffing crisis. The guide includes recommendations to review COVID-19 federal and state guidelines to ensure patient and staff safety and to assist in adjusting workflows to support both staff and patients.
Prior Authorization Requests Must Now be Submitted through Workers’ Comp Portal
Effective May 2, 2022, the New York State Insurance Fund will no longer accept Prior Authorization Requests (PAR) directly from providers. All PARs must be submitted through the Workers’ Compensation Board’s OnBoard portal, which will automatically route the request to the appropriate claim administrator for review. Paper forms can no longer be faxed, emailed, or mailed.
Please visit the Board’s website for information on how to register for the WCB portal.
Classified Ads Available for:
Physicians’ search services • allied medical placements • locum tenens • practice valuation • practice brokerage • practice consulting • real estate
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Rendr- Transforming Healthcare – Primary Care Opportunity: Internal or Family Medicine Physician, Bilingual English and Chinese (Mandarin or Cantonese)
Job Position: Internal Family Medicine Physician please send resumes to: firstname.lastname@example.org. We are offering employment opportunities to Internal or Family Medicine Physicians who are interested in providing high-quality clinical care to our patients in the diverse communities that we serve. As a rapidly growing network, we provide a supportive environment for our physicians to practice medicine
under the guidance of dedicated medical leadership. www.rendrcare.com.
Job Position: Clinical Operations Medical Director in this role, you will provide clinical oversight and help lead our team of providers to assure high standards of care for our patients. The ideal candidate will be dedicated to improving the health of the communities we serve and will be a practicing physician as well as an established medical leader with proven experience improving clinical operations and building strong teams. Please send resumes email@example.com. We are offering leadership opportunities to Physicians who are interested in providing high-quality clinical care to our patients in the diverse communities that we serve. As a rapidly growing network, we provide a supportive environment for our physicians to practice medicine under the guidance of dedicated medical leadership. www.rendrcare.com.