News Clips
Inside Indiana Business: Mixed testimony on cumulative health care bill (2/1) – A wide-ranging bill aimed at lowering health care costs for Hoosiers received mixed reviews in committee on Tuesday. The bill includes a provision to incentivize independent practices by giving doctors unaffiliated with a large health system a $1,000 tax credit for a handful of years. Additionally, only critical access hospitals would be allowed to include non-compete clauses into physician contracts – a concept also under consideration in the Senate.
Medical Economics: Physician payment outlook (1/31) – Physicians treating Medicare patients will receive a two percent pay cut in 2023. “We were advocating for physicians to receive an update commensurate with inflation, but we certainly didn’t get an inflation update,” says Anders Gilberg, MGMA. Payers are increasingly tying compensation to the amount of risk assumed by physicians, and this can put more pressure on private physicians than on those employed by larger medical systems. Primary care physicians are critical for the industry’s shift to value-based care. “As an independent primary care physician, they need to think about cooperatives or health plans that have the capabilities to support them. We are starting to see some health plans provide better insights, services and health capabilities. They also need to consider the fundamental question on going alone or joining an aggregator — whether that’s large, increasingly integrated health systems or the rise of some of the larger physician groups often supported by private equity.”
Fierce Healthcare: Private equity owns at least 130 rural hospitals, and other revelations in a sweeping new report on PE in rural healthcare (1/31) – Steady private equity activity in rural health care warrants heavier scrutiny and regulatory reform, argues a new report from the Private Equity Stakeholder Project (PESP). PESP found that private equity firms own at least 130 rural hospitals, with the highest concentration being in the south. Texas had the most, with 17 hospitals, followed by Kentucky and North Carolina. “Generally speaking, rural health care providers are in greater need for capital and so they’re more willing to accept private equity ownership.” Opportunity for consolidation is another attractive feature of rural hospitals, though private investment is found everywhere.
Modern Healthcare: What the end of the federal COVID-19 emergency means for healthcare (1/31) – The public health emergency has been in place since January 2020. But without new policymaking, these are the key federal policies that will go away when the public health emergency declaration lapses in four months: Physicians whose privileges at hospitals or ambulatory surgical centers have expired, or new physicians who haven't gotten full approval yet, can continue practicing at the hospital to assist with COVID-19-related workforce shortages. CMS also allowed virtual supervision of medical residents. Hospitals have been allowed to use alternative patient care sites, as long as the locations are approved by the states in which they operate.
RevCycle Intelligence: Plagued by High Expenses, Half of Hospitals Finish in the Red (1/31) – About half of US hospitals finished the year with a negative margin as they struggled to keep revenue up enough to cover rising expenses in 2022. Physicians also felt the brunt of overall rising costs, according to the “Physician Flash Report,” an accompanying analysis of more than 200,000 physicians and advanced practice providers from 100 different specialties. Labor and non-labor-related expenses leading to continuing negative operating margins despite significant improvements in productivity and, therefore, revenue. Group practices should “seek to improve individual provider productivity and efficiently integrate advanced practice providers to meet the increase in volume and successfully bend the cost curve.”
Commonwealth Fund: U.S. Health Care from a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes (1/31) – While the U.S. spends more on health care than any other high-income country, the nation often performs worse on measures of health and health care. For the U.S., a first step to improvement is ensuring that everyone has access to affordable care. A second step is containing costs. U.S. policymakers and health systems could look to some of the approaches taken by other nations to contain overall health spending, including health care and administrative costs. A third step is better prevention and management of chronic conditions. Critical to this is developing the capacity to offer comprehensive, continuous, well-coordinated care. Decades of underinvestment, along with an inadequate supply of health care providers, have limited many Americans’ access to effective primary care.
Fierce Healthcare: 'I cry and no one cares': Medscape survey shows doctor burnout, depression is getting worse (1/30) – Physician burnout and depression continue to worsen, according to a new report
from Medscape. In the survey, more than half of physicians said they are feeling burned out, up from 42 percent saying so in 2018 and 47 percent in 2021. Nearly a quarter also reported being depressed in 2022. The specialties most affected have shifted; the number of emergency medicine doctors, family physicians and internists experiencing burnout is up compared to five years ago. This year’s report showed less burnout in solo practices than in other work settings thanks to autonomy and having control over productivity. Some doctors might consider switching their form of practice to help reduce burnout, Kane suggested.
Winston-Salem Journal: NC Senate bill would give attorney general more oversight over health-care system deals (1/30) – A bipartisan state Senate bill would require health-care systems to submit acquisition and merger proposals for state attorney general review before reaching any agreement. The attorney general’s office conducts anti-trust reviews of hospital merger applications. Attorney General Josh Stein, a Democrat, has expressed skepticism and criticism of recent high-profile health care transactions. “The bill addresses the concern that, currently and historically, legal authority has been lacking for oversight of these matters.” Stein said his authority over health-care system transactions “is inconsistent depending on what type of entities (not-for-profit or for-profit) are involved, the ownership entity, and how the transaction is structured — a merger, a sale of assets, a joint venture or a lease.”
Forbes: Big Retail Enters Healthcare: Disruption Can Be A Good Thing (1/30) – With a growing number of “big box” retailers investing heavily and staking their futures on primary care, the industry is awash with speculation as to what it all means to various health care stakeholders. Perhaps the most important questions center on how all of this will impact patient care and advance value-based models. With so many new entrants providing point services, the potential exists for patient care to become disjointed and for care quality to suffer. But the new entrants could actually accelerate the momentum of value-based care. There is a shortage of primary-care physicians—a situation that not only hinders access to care but stymies the progress of value-based models. Although U.S. health care largely continues to operate in a fee-for-service model, many of the investments by the big retailers are emphasizing value-based care, which should lead to a concentrated focus on prioritizing patient health and keeping them out of hospitals.
Dallas Morning News: How one bad law drives hospital consolidation and high health care costs (1/28) – One often overlooked cause of soaring health care costs is hospital consolidation. Many hospital acquisitions these days are driven by a single well-intended but poorly written policy, the 340B Drug Pricing Program. As a study in the New England Journal of Medicine observed, the program doesn’t require hospitals to use their 340B savings to improve care for underserved patients and imposes only minimal oversight as to whether they’re supporting that mission at all. All this has encouraged acquisitions to the point that now, the 10 largest health care systems in the United States control nearly one-quarter of all hospitals. The only solution is for Congress to revise the law, enacting safeguards that return 340B to its intended purpose.
STAT: Health systems have much higher prices, only marginally better quality, new study finds (1/24) – The claims have become almost ubiquitous. Hospital CEO after hospital CEO stands at a podium and promises the merger being announced will improve quality and lower costs. Once deals close, though, there tends to be little, if any, follow-up to determine whether those things actually happened. A new Journal of the American Medical Association study
adds to the growing body of evidence that they don’t. The authors looked across a large swath of the country’s hospitals and physicians found that while quality did improve marginally, the prices paid for services delivered by health system hospitals and doctors was significantly higher than their non-system peers.
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