Hospitals and Corporations Own Nearly Half of U.S. Physician Practices
COVID-19 Accelerated Ownership Trend, New Analysis Finds
Nearly 70% of U.S. physicians are now employed by hospital systems and corporate entities like private equity firms and health insurers according to new data by Avalere for the Physicians Advocacy Institute (PAI) examining the period between January 1, 2019 and January 1, 2021.
The research found that the COVID-19 pandemic accelerated a long-term national trend of hospitals and corporate entities acquiring physician practices and employing physicians. During the two-year period, these entities acquired 20,900 additional physician practices. Forty-eight thousand additional physicians left independent practice for employment by hospital systems or other corporate entities.
“COVID-19 exacerbated financial vulnerabilities of physician practices and forced them to make difficult decisions,” said Kelly Kenney, chief executive officer of PAI. “The practice acquisition trend has potentially serious implications for competition and health care costs, which have been shown to increase with this type of marketplace consolidation.”
Every U.S. region experienced these national trends of steady growth in employment and acquisitions, with an uptick in the last half of 2020. The cumulative findings by Avalere researchers during the two-year period revealed:
• Hospitals, health systems, and corporate entities now own nearly half of the nation’s medical practices.
• The sharpest increase in physician practice acquisitions and employment was among corporate entities such as private equity firms and health insurers (32%).
• Across regions, hospital ownership of practices grew between 6 percent and 11 percent and corporate ownership grew between 44 percent and 59 percent.
PAI believes that physicians should be in the driver’s seat when it comes to managing their patients’ medical care. “Regardless of the practice setting, physicians must retain autonomy to make clinical decisions, free from interference by corporate entities motivated primarily by profits,” said Kenney.
PAI will continue to work with Congress and state policymakers to champion policies that enable physician-led organizations and independent physician practices to compete with larger corporate entities to deliver health care services to patients.
As State Ends Emergency Declaration, What Does that Mean for Telehealth Coverage?
When Governor Cuomo announced last week an end to the state’s “emergency” declaration and an end to the many Executive Orders waiving portions of New York laws and regulations, it prompted several questions from physicians and their staff as to what coverage will continue to exist for telehealth services for their patients.
The following is a brief update on the range of issues regarding access to telehealth services that MSSNY will continue to address over the summer and fall, as well as during the 2022 legislative session.
• Coverage Parity Continues Existing state law requires New York regulated health insurance companies to provide coverage for Telehealth services for care that is covered on an in-person basis. NY state law also requires Telehealth coverage by Medicaid. These policies do not address payment levels for physicians and are not affected by suspension of the public health emergency, so “coverage parity” for Telehealth services will continue. These policies do not apply to ERISA regulated plans.
• Waiving of Cost-Sharing Ends DFS recently ended its emergency regulation that required insurers to waive cost-sharing requirements on patients for services delivered via Telehealth. MSSNY raised concerns with regulators, but it may be harder to justify given the very significant drop in COVID cases over the last two months.
• Audio-Only Coverage The latest emergency regulation from DFS continues coverage for Telehealth services delivered via audio-only until July 5, but it is unclear if DFS will renew, making clarifying legislation potentially necessary. Please note that last year a statute was enacted that requires Medicaid to cover audio-only Telehealth. The New York State Department of Health recently issued a guidance document for how Medicaid will continue to cover telehealth services, including through audio-only COVID-19-Telephonic-and-Telehealth-06-25-21.pdf (hca-nys.org).
• Telehealth thru FaceTime? At this time, it is unclear whether DFS guidance from last March (Coronavirus (COVID-19) information: Information for Insurers and Providers on Coverage for Telehealth Services | Department of Financial Services (ny.gov) regarding the approved use of simplified modalities for delivering Telehealth services will be continued. MSSNY is seeking clarification.
However, the DOH notice referenced above does suggest that approved use of simplified technologies will continue as they note that: “during the COVID-19 federally declared public health emergency, the Department of Health and Human Services Office for Civil Rights (OCR) has issued a Notification of Enforcement Discretion for telehealth remote communications. OCR will exercise its enforcement discretion and will not impose penalties for noncompliance with the regulatory requirements under the HIPAA Rules against covered health care providers in connection with the good faith provision of telehealth during the emergency”.
• Continued Push for Payment Parity Some health insurers made the decision to increase telehealth payments to match in-person payments. However, many insurers did not follow the same path. MSSNY will continue to work with other patient and physician groups in support of legislation such as A.6256/S.5055 that would require health insurers to ensure payment for Telehealth services are equal to similar services provided in-person.
We understand that the pandemic significantly transformed the use of telehealth services, creating new options for patients to receive care and their physicians to deliver care. To that end, MSSNY will continue to advocate for measures that remove barriers to patients receiving Telehealth services from their physicians, including ensuring fair payments for these services.
Do You Have Long-Haul COVID Patients in Your Practice? USA Today Reporter Looking for NY Patients to Interview for National Story
A reporter with USA Today is looking to set up interviews with long-haul COVID patients in New York. The story will focus on patients who have had financial struggles, including but not limited to challenges returning to work, filing disability claims, or health insurance coverage struggles. The national story will appear in USA Today and outlets across the country.
If you have patient(s) willing to share their stories, please send contact information to Roseann Raia at MSSNY.
Physicians Still Top Choice for Patients According to National Tracking Poll
Conducted between April 29-May 2, 2021, the Morning Consult’s National Tracking Poll sampled 2,200 adults on healthcare usage and trust. The interviews were conducted online and the data was weighted to approximate a target sample of adults based on gender, educational attainment, age, race, and region. In general, the study found that adults were more likely to say they would select a physician’s office over a retail health clinic or an urgent care center for a variety of healthcare services, though there were significant differences by the age of the respondent.
- 59% of adults said they trust their primary care doctor a lot, while 24% said they trust the healthcare industry, and only 15% said they place a lot of trust in retail health clinics.
- 70% of adults would select a physician’s office for wellness checkups, and 67% for blood work, while 62% would select a physician’s office for diagnosing and treating common illnesses and 56% for vaccinations.
- 84% of adults said cost of services is somewhat or very important when it comes to retail health clinics.
- There was a significant difference by age of almost 30% between adults under 35 and those 65 or older when it came to their preference for getting a wellness visit, treating a common illness, and getting blood work done at a physician’s office. Almost half of adults under 35 said they would go to a physician’s office for this care, while more than 4 in 5 adults 65 or older would go to a physician’s office.
–Morning Consult National Tracking Poll | April – May 2021 Click here to view the full report.
American Conference on Physician Health Sponsored by AMA, Mayo Clinic, and Stanford University
The 2021 American Conference on Physician Health (ACPH) joint scientific conference promotes scientific research and discourse on health system infrastructure, and the actionable steps organizations like yours can take to improve physician well-being.
Sponsored jointly by the Mayo Clinic, Stanford University and the American Medical Association, this year’s conference theme is, “Achieving the quadruple aim: Resilient systems in times of crisis.” Participate in topical and relevant sessions with presenters and attendees from around the globe, while gaining valuable knowledge and information about best practices and tools to improve professional satisfaction in your medical practice.
Conference registration and hotel reservations
- Registration rates: Available through Thursday, Sept. 23.
- To register for the conference and view agenda, visit the ACPH 2021 homepage.
- Hotel room rates: Special pricing for ACPH attendees available until Sept. 13 ($299 USD/night).
- Check out the ACPH conference website for all your planning needs—including the agenda, speaker bios, travel information, registration inclusions and more!
Deadline Approaching to Comment on the ABMS Draft Standards for Continuing Certification
The deadline to comment on the American Board of Medical Specialties (ABMS) “Draft Standards for Continuing Certification – Call for Comments” is approaching. Opened on Tuesday, April 20, the 80-day period to obtain input and feedback from all stakeholders who possess, use, or rely upon board certification will close on Thursday, July 8, 2021 at 11:59 p.m. CT. Feedback received during the open Call for Comments will guide and inform the development of the final Draft Standards for Continuing Certification (“Draft Standards”), which will be considered by the ABMS Board of Directors in October 2021.
The new Draft Standards reflect foundational changes to the manner in which ABMS and its Member Boards deliver on their mission, bringing value to both the profession and the public at large. They were developed after a year of deliberation with key stakeholders in response to the recommendations of the Continuing Board Certification: Vision for the Future Commission as well as of the wider stakeholder community.
Structured to support and provide diplomates with the tools they need to stay current in medical knowledge; the Draft Standards prepare them to address emerging medical and public health issues; and help them identify and address opportunities for practice improvement within the systems in which they work, in a way that enhances relevance and reduces burden. The Draft Standards also address the needs of patients, families, and communities by assuring that board certified diplomates maintain the knowledge and skills necessary to deliver the quality specialty care upon which they rely.
To review and comment on the Draft Standards, visit the Draft Standards for Continuing Certification section on the ABMS Website by 11:59 p.m. CT on Thursday, July 8, 2021. Please feel free to share the “Draft Standards for Continuing Certification – Call for Comments” with your colleagues and others who may have an interest in them and encourage them to share their feedback to ensure that all stakeholder perspectives are considered in the finalization of the standards that will guide the specialty care practice of the future.
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For help, information or to place your ad, call Roseann Raia at 516-488-6100 ext. 302
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