News Clips
KFF Health News: More Patients Are Losing Their Doctors — And Trust in the Primary Care System (4/2) – The loss of a trusted doctor is never easy, and it’s an experience that is increasingly common. The stress of the pandemic drove a lot of health care workers to retire or quit. Now, a nationwide shortage of doctors and others who provide primary care is making it hard to find replacements. And as patients are shuffled from one provider to the next, it’s eroding their trust in the health system. The American Medical Association recently called the physician shortage a “public health crisis “As private practices close or get smaller, we are seeing patient demand go up at the health centers,” said Elena Nicolella, Rhode Island Health Center Association, or RIHCA president. “Now with the workforce challenges, it’s very difficult to meet that patient demand.”
KFF Health News: Hospitals Cash In on a Private Equity-Backed Trend: Concierge Physician Care (4/1) – Some concierge physicians say their more attentive care means healthier patients. A study published last year by researchers at the University of California-Berkeley and University of Pennsylvania found no impact on mortality rates. What the study did find: higher costs. Using Medicare claims data, the researchers found that concierge medicine enrollment corresponded with a 30-50 percent increase in total health care spending by patients. For hospitals, “this is an extension of them consolidating the market,” said Adam Leive, a study co-author and an assistant professor of public policy at UC Berkeley.
Highland County Press: Independent physician practices are disappearing, and that's bad for patients (3/30)
– The health care market has been consolidating for decades. As of 2021, more than half of doctors worked for hospitals or health systems, according to research conducted by Avalere Health for the Physicians Advocacy Institute. Forty years ago, by contrast, roughly three-quarters of physicians worked in their own medical practices. Independent practice offers patients and the health care system many benefits. Research shows that independent physician practices have more success getting patients to follow a prescribed treatment plan and post significantly lower rates of preventable hospital admissions and readmissions. Their patients also report higher levels of satisfaction.
Annals of Family Medicine: Small Independent Primary Care Practices Serving Socially Vulnerable Urban Populations (3/30) – In 2020, in urban areas across the United States, 19.3 percent of family physicians served in independent practices with one to five clinicians, down from 22.6 percent in 2017. Nearly one-half of these physicians reported that >10 percent of their patients were socially vulnerable. Interviews with 22 physicians who reported that the majority of their patients were socially vulnerable revealed five themes: (1) substantial time spent addressing access issues and social determinants of health, (2) minimal support from health care entities, such as independent practice associations and health plans, and insufficient connection to community-based organizations, (3) myriad financial challenges, (4) serious concerns about the future, and (5) deep personal commitment to serving socially vulnerable patients in independent practice.
Healthcare IT News: AI can help providers get better outcomes in value-based care models (3/29)
— The momentum of value-based care is poised to accelerate. CMS has outlined an ambitious objective: to transition all traditional Medicare beneficiaries into a VBC arrangement by 2030 – a notable increase from the mere seven percent recorded in 2021 by Bain research. As more health plans, providers and members enter VBC arrangements, substantial volumes of clinical data will need to be managed effectively to oversee patient risk and care quality. This article discusses the potential of artificial intelligence to revolutionize risk adjustment, how AI can synthesize both quality and risk adjustment clinical data, and how providers can use AI tools to help patients fully engage in their care.
Modern Healthcare: How private equity-backed staffing companies impact providers (3/27) – Private equity firms have invested in a record number of clinical staffing companies since 2020 and some doctors worry health systems' use of these companies could mean higher patient loads and understaffing. Opponents argue that contracting with the private equity-backed staffing company will lead to worse patient care outcomes and, likely, lower provider pay. From 2020 through 2023, private equity firms acquired 116 health care staffing companies and were involved in more than 60 percent of all clinical staffing transactions, according to a data analysis by The Braff Group, a mergers and acquisitions advisory firm.
JAMA: Primary Care Physicians’ Satisfaction With Interoperable Health Information Technology (3/26) – In this survey study of 2088 physicians, 70 percent indicated being at least somewhat satisfied with access to outside information. However, only 23 percent indicated that it was very easy to use outside information, and very few (eight percent) indicated that it was very easy to use information from different electronic health record systems. The findings of this study suggest that six years after the 21st Century Cures Act, the policy goal of ubiquitous, high-value interoperable health information appears to remain a work in progress with heterogeneous barriers—including both too much information and missing information—limiting the value of interoperability.
MedPage Today: Medicare Debuts Another Primary Care-Focused Accountable Care Model (3/26) – Medicare is trying again with another accountable care organization (ACO) payment model aimed at primary care doctors, but reactions to the new model are mixed so far. The voluntary model, known as ACO Primary Care Flex, would pay organizations that participate in Medicare's Shared Savings Program a monthly fee that would be distributed to the ACO's primary care practices. The CMS announced the new model last week; it will begin operating on Jan. 1, 2025. The model is aimed at low-revenue ACOs, "which tend to be smaller and mainly made up of physicians," according to CMS. "Low-revenue ACOs have historically performed better in the Shared Savings Program, demonstrating more savings and stronger potential to improve the quality and efficiency of care delivery. The ACO PC Flex Model's payment structure also promotes competition by providing a pathway for low revenue ACOs, which often have fewer resources, to continue serving people with Medicare while providing an alternative for physicians to stay independent."
Modern Healthcare: States push to rein in hospital prices amid site-neutral debate (3/25) – More states are cracking down on hospital prices, despite a lag in federal policy reform. Last year, Indiana, Colorado, Connecticut and Maine passed laws restricting facility fees, which are additional charges hospitals bill to patients who receive care at hospital-owned clinics and outpatient facilities. About a dozen states, including those four, have or are considering passing such laws, which range from prohibiting facility fees for certain services to disclosure requirements. States are stepping up as the latest federal push to equalize payments for care delivered at independent physician offices versus hospitals-owned outpatient facilities sputtered. Policy experts, employers and physicians are not counting out congressional action this year. However, more states are expected to introduce facility fee legislation in the meantime.
Wall Steet Journal: Hospitals Are Adding Billions in ‘Facility’ Fees for Routine Care (3/25) – Hospitals are adding billions of dollars in facility fees to medical bills for routine care in outpatient centers they own. Once an annoyance, the fees are now pervasive, and in some places they are becoming nearly impossible to avoid, data compiled for The Wall Street Journal show. The fees are spreading as hospitals press on with acquisitions, snapping up medical groups and tacking on the additional charges. The fees raise prices by hundreds of dollars for widely used and standard medical care, including colonoscopies, mammograms and heart screening. The added cost isn’t justified, physicians and economists say. Medicare advisers said last year the federal insurer likely overpaid for a sample of services by about $6 billion because of the fees in 2021.
The Hill: Patients deserve to know whether private equity owns their health care – Op-ed by Brandon Novick (3/21)
– Americans should be able to know who controls their health care choices. The American health care system is littered with different for-profit entities trying to make as much money as possible, often at the expense of people’s well-being. As private equity firms gobble up health care providers, it is increasingly important for patients to have the ability to spot the worst actors and make informed choices about their own care. Fortunately, CMS finalized a rule in November 2023 which will increase transparency for millions of Americans, namely seniors. The rule requires that all health care providers that enroll with Medicare disclose if they are owned by a private equity company. Ultimately, the new CMS rule is an important step forward for transparency, allowing the government and researchers to better track and study the effect of private equity ownership across the health care system.
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