Do you remember the last time you had an extensive conversation with your primary care physician about your overall health? No? Me, either. As you know from your line of work, many doctors are so busy these days with administrative tasks and reporting to CMS for reimbursement. Complying with MACRA and other healthcare regulations is no easy job.
A study published in the Annals of Internal Medicine found that physicians spent only 27 percent of their average shift with patients, and only 52.9 percent of that was focused on direct clinical face time. Almost half of each shift was spent on EHRs and desk work. That doesn’t count all the work support staff does to keep a practice running smoothly.
Improved Patient Care Through Personalized Care
Independent and small physician practices typically provide more personalized care. Did you know, though, that they also boast lower per-beneficiary costs and a lower 30-day readmission rate compared to hospitals? In addition, they reduce avoidable hospitalizations by 33 percent.
Some physicians prefer to work in a small-scale setting where they can more easily practice care management, often resulting in both patient and job satisfaction. They’re not required to answer to multiple levels of bureaucracy like some of their colleagues employed by large health systems. Another advantage? Less burnout.
Common Challenges for Small Practices
Now the negatives. Small and independent physician practices sometimes struggle with recruiting and retaining competent staff, adapting to new models of care, meeting regulatory standards and keeping up with the overall cost of doing business. If you work in a small practice, you know that.
They don’t usually have the resources of a large physician group, including power to negotiate with payers. Many independent physician practices have the doctor performing tasks such as patient access and billing that are usually relegated to support staff.
These challenges were outlined in Kareo’s State of the Independent Practice Industry Report, through which more than 70 percent of the 800 respondents surveyed agreed that increasing demands on provider time and the time demands of administrative challenges are impacting care delivery. More than 60 percent of respondents noted declining reimbursements from third-party payors.
The Kareo report also found that approximately 70 percent of independent practices cite technology as necessary to improve their efficiency and profitability, with more than half adopting solutions specific to patient engagement. Resistance to this technology often emanates from practices that don’t want to invest a lot of capital into new technology: researchers at Vanderbilt University Medical Center (VUMC) found that private practices lag behind healthcare providers in group practices and hospitals in EHR use and health IT adoption.
These challenges point to some of the reasons for the move of many physicians to employment with hospitals and health systems and large physician groups. The numbers back it up:
- Physician-owned practices see 990.8 million visits (3.1 visits per person) each year in the United States, but hospital outpatient visits total 125.7 million visits (4 visits per person).
- The percentage of doctors practicing independently declined from 41 to 17 percent between 1983-2014.
- Between that same time period, the percentage of physicians employed in practices with 25 or more doctors quadrupled.
- From 2004-2011, hospital ownership of physician practices increased from 24 to 49 percent.
- In 2018, 47.4 percent of practicing physicians were employed, and 45.9 percent owned their practices. The share of physicians who are owners decreased by more than seven percentage points between 2012-2018.
- Older physicians are more likely to have practice ownership – 54.3 percent among physicians 55 and older and 25.5 percent among those under 40.
Investing in Patient-centered Technology
Even though these statistics show a trend of more physicians seeking employment with a hospital or health system, most Americans aren’t in favor of it. According to a survey, almost 70 percent of U.S. residents want Congress to curb healthcare consolidation, and 60 percent believe independent practices being acquired by larger healthcare enterprises is a threat to affordable care. About one-quarter even see this consolidation trend as a direct threat to their health.
This time, patients might be correct. Another study, this one published in the Journal of General Internal Medicine, found that not only do patients spend more when treated by physicians billing through a hospital-owned practice, they also don’t get better quality care.
If your practice is independent, it’s important to invest in technology solutions in a strategic method. The options you choose should increase quality of care for patients but also streamline processes, enhance revenue cycle management and reduce medical errors.
In the previously-referenced Kareo report, almost 80 percent of independent practices cite the goal of improving patient engagement, although only half of them are utilizing software for that purpose. Employing technology solutions for patient engagement enables time savings for both the patient and provider, leaving more time to focus on care. It automates a multitude of those pesky administrative tasks, allowing staff to focus on other job duties. This all leads to patient satisfaction and a financially successful practice, no matter how many physicians it includes.