Nervous Group Practice Leaders See Mixed Picture Ahead
A survey of 112 independent physician practice executives nationwide has uncovered a range of perspectives on the current state of group practices, and frankly, a mix of apprehension and some positivity for the future. The survey results were reported by Jesse Noyes, a vice president of marketing at Tebra, a Corona del Mar, Calif.-based provider of practice automation software for independent healthcare practices.
Posting the survey’s results on Tebra’s website, Noyes wrote on Aug. 3 that, “When asked about the state of independent healthcare practitioners today, over a third of respondents viewed the state of independent healthcare practitioners as poor or terrible, while 32 percent found it acceptable; 27 percent considered the industry good, and only 6 percent rated it as excellent.” What’s more, “Nearly half considered the independent healthcare model to be at least somewhat threatened.” Drilling down, “Many practice owners expressed concern about the industry's future: 8 percent found it extremely threatened, while 21 percent believed it to be very threatened. Nearly half (44 percent) considered the independent healthcare model to be at least somewhat threatened. Only a small percentage, 6 percent, believed it faced no threat at all.”
Per those survey results, Noyes quoted Lauren Wheeler, a former family medicine physician who currently works as a healthcare advocate and medical editor, as saying that "Independent practice owners are, by many metrics, correct in assessing the state of the industry as threatened.” Indeed, Wheeler stated, “Decreasing Medicare and Medicaid payments, whether in absolute terms or relative to inflation, poses a dire obstacle to the independent practice owner because these are the insurance rates that they don't have to independently negotiate for their practice every year or two. Contrast that to the myriad of private insurance options with variable reimbursement rates and innumerable rules and exceptions, and it becomes clear why private practices both choose to cater to those with public insurance and are hurt by reimbursement changes."
At the same time, Noyes noted that “More than a third of practice owners anticipate growth this year,” while it is also true that “A majority of practice owners expect to remain independent over the next five to 10 years.”
Also, Noyes wrote that, “Despite pessimistic views of the industry, a majority of practice owners expect to remain independent over the next 5 to 10 years. A total of 26 percent find it completely likely, 30 percent find it very likely, and 25 percent find it somewhat likely. Only 19 percent say it was unlikely, with 11 percent selecting hardly likely and 8 percent selecting not at all likely.”
There is some nuance there, though, as the report also referenced statistics from the Physicians Advocacy Institute, finding that approximately 75 percent of physicians are considered employees rather than owners. This represents a significant change in ownership structure compared to 2005, when physician-owned practices accounted for two-thirds of the total.
Survey respondents expressed that “The primary threats to independent practices, as cited by owners, are low reimbursement rates (68%), declining margins/profits, and staffing shortages (both at 50%). Other concerns include overhead (49%), difficulty with health insurance and rising healthcare costs (both at 46%), and competition with larger healthcare organizations (44%).”
There’s also this: Noyes wrote that “A recent survey run by Tebra found that 42 percent of hospital system employees are considering switching to private practice, mostly due to the need for a better work-life balance. Our research supports the hypothesis that burnout is less of a factor in private practices,” he went on. “Among the primary threats to their practices, owners mark burnout near the bottom at 39 percent, behind difficulty with insurance (46 percent), rising cost of healthcare (46 percent), and competition from larger healthcare organizations (44 percent). Only billing problems (28 percent), speed of reimbursements (26 percent) and the patient population getting sicker (15 percent) rank lower. While 54 percent of independent practice owners experience moderate burnout,” he noted, “19 percent report hardly any burnout, and 10 percent claim no burnout. Only 14 percent are experiencing severe burnout and 3 percent are experiencing extreme burnout. And these results are skewed based on the practices’ performance. A large percentage of those reporting extreme burnout — 67% — say the state of their practice is terrible or poor.” Meanwhile, “Respondents who say their practice is excellent or good reported no extreme burnout. Sixty-two percent of respondents who say they’re experiencing severe burnout say the state of their practice is poor or terrible, while only 25% are in the excellent or good cohort.”
