BASED ON A WHITE PAPER CONDUCTED FOR: THE PHYSICIANS FOUNDATION
|
|
- Ernest Sims
- 8 years ago
- Views:
Transcription
1 HEALTH REFORM AND THE DECLINE OF PHYSICIAN PRIVATE PRACTICE Presented To BASED ON A WHITE PAPER CONDUCTED FOR: THE PHYSICIANS FOUNDATION 1
2 Signatory Medical Societies: Alaska State Medical Association California Medical Association Connecticut State Medical Society Denton County Medical Society (Texas) El Paso County Medical Society (Colorado) Florida Medical Association Hawaii Medical Association Louisiana Medical Association Medical Association of Georgia Medical Society of New Jersey Medical Society of New York Nebraska Medical Association New Hampshire Medical Society North Carolina Medical Society Northern Virginia Medical Societies South Carolina Medical Association Tennessee Medical Association Texas Medical Association Vermont Medical Society Washington State Medical Association FIVE COMPONENTS 1. Reform provisions affecting doctors 2. A national survey of physicians 3. Physician practice model case histories 4. Analysis: physician workforce implications 5. Analysis: legal implications for physicians 2
3 A FOCUS ON PHYSICIANS. HOW DID WE GO FROM THIS TO THIS? 3
4 AND WHY ARE WE HEADED TO THIS? FROM WHAT HAS CHANGED AND WHAT HAS NOT 4
5 A HAMBURGER IS STILL A meat patty and lettuce on a bun cents 2010.$1 HEALTHCARE: NO LONGER TAKE TWO ASPRIN Close to 200 Board Certified Specialties Over 10,000 prescription drugs Organ Transplants Face Transplants Teleradiology/Telemedicine Non-invasive Techniques Gene Therapy 5
6 million people 2011 HEALTHCARE: FROM BIG million people TO REALLY BIG 6
7 MORE PEOPLE AND OLDER PEOPLE 75 million baby boomers started turning 65 in One every 8 seconds SOMETHING HAS COME BETWEEN US, OUR DOCTORS, AND HEALTHCARE DELIVERY MONEY Virtually limitless demand vs. finite resources $3 TRILLION AND COUNTING A MODEL THAT IS NO LONGER SUSTAINABLE 7
8 IN TWO DAYS, WE SOLVE THE RIDDLE RES IPSA LOQUITUR The Thing Speaks for Itself 16 8
9 THE IMPACT ON DOCTORS What does reform mean to physicians and to their patients? Two types of reform: Formal. PPACA Informal. Market/societal forces WHITE PAPER KEY FINDINGS: This time, no FALSE DAWN 9
10 KEY FINDINGS: The independent, private practice model will be largely (though not uniformly) replaced. Physicians will consolidate, be employed, or align with larger entities KEY FINDINGS: REGIONAL VARIANCE/PREVAILING MODELS ACOs (Medicare & Commercial) Larger, non-aligned groups Larger, aligned groups Medical homes Community Health Centers Concierge practices Smaller, aligned groups Traditional private practice 10
11 OBSTACLES TO FORMING AN ACO Physician staffing/alignment...42% Lack of Capital..38% Lack of integrated IT systems..32% Lack of evidence-based protocols..25% Source: AMN Healthcare 2011 ACO Survey KEY FINDINGS: THE MEDICAL PRACTICE ENVIRONMENT: FURTHER EROSION Through acts of omission and commission, reform is, on balance, a net loss for physicians and will further erode the medical practice environment No payment fix (SGR) Tort reform not addressed Onerous compliance regulations More patient volume Higher patient acuity Problematic cost/quality tracking Increased office expense Status quo (pre-authorization, multiple forms) largely intact 11
12 KEY FINDINGS: REFORM WILL EXACERBATE THE PHYSICIAN SHORTAGE Supply provisions inadequate to meet demand Access issues for Medicaid, Medicare and other patients Primary care/specialist disparities to continue Many physicians will cut back or opt out Physicians will redefine their roles, rethink delivery models DID ANYBODY ASK WHAT PHYSICIANS THINK? SURVEY OF PHYSICIANS AND HEALTH REFORM Thank you for asking 12
13 RESULTS: WHAT WAS YOUR INITIAL REACTION TO PASSAGE OF HEALTH REFORM? 60% 50% 52% 40% 30% 20% 10% 12% 15% 6% 15% 0% Very Positive Somewhat Positive Neutral Somewhat Negative Very Negative RESULTS: HOW DO YOU FEEL NOW ABOUT HEALTH REFORM? 60% 50% 40% 30% 20% 10% 0% 10% I am more positive than I was initially 51% My feelings have not changed 39% I am more negative than I was initially 13
14 RESULTS: DO YOU BELIEVE THE VIEWPOINT OF PHYSICIANS WAS ADEQUATELY RESPRESENTED TO POLICY MAKERS AND THE PUBLIC DURING THE RUN-UP TO PASSAGE OF HEALTH REFORM? 14% Yes 86% No No Yes RESULTS: WHICH BEST DESCRIBES YOUR ATTITUDE TOWARD MEDICAL PRACTICE BEFORE REFORM WAS ENACTED? 40% 35% 30% 25% 20% 15% 10% 5% 0% 14% Very Positive Somewhat Positive 37% 36% Somewhat Negative 13% Very Negative 14
15 RESULTS: WHICH BEST DESCRIBES YOUR MEDICAL PRACTICE NOW THAT REFORM HAS BEEN ENACTED? 35% 30% 29% 33% 32% 25% 20% 15% 10% 6% 5% 0% Very Positive Somewhat Positive Somewhat Negative Very Negative RESULTS: DO YOU BELIEVE REFORM WILL COMPEL YOU TO CLOSE OR SIGNIFICANTLY RESTRICT YOUR PRACTICE TO ANY CATEGORY OF PATIENT? 60% Yes 40% No No Yes 15
16 16% 16% 14% 14% 12% 12% 12% RESULTS: IF YES, PLEASE INDICATE ALL THAT APPLY: CLOSE SIGNIFICANTLY RESTRICT Medicaid. 51%..42% Medicare. 30%. 57% Indigent 43%. 38% Patients covered through exchange 24%. 44% Some HMO/managed care patients 17%. 42% All New patients.. 5%.. 37% Self Pay %.. 24% Privately Insured.. 3%... 18% Other.. 6%... 9% CONSIDER YOUR PRACTICE PLANS OVER THE NEXT THREE YEARS AS REFORM IS PHASING IN. DO YOU PLAN TO: 30% 26% RESULTS: 25% 20% 19% 15% 11% 10% 8% 6% 4% 5% 0% 16
17 IF YOU COULD MAKE A STATEMENT TO POLICY MAKERS AND THE PUBLIC ABOUT HEALTH CARE REFORM AND THE STATE OF THE MEDICAL PROFESSION TODAY, WHAT WOULD YOU SAY? 1,200 written responses The bill is too long and comprehensive to know what is coming. I fear the unknown. SURVEY CONCLUSION Physicians are being systemically disengaged from the practice of medicine The Result: LIMITS ON PATIENT ACCESS 17
18 REFORM AND THE PHYSICIAN WORK FORCE WHO WILL SEE THE 32 MILLION NEWLY INSURED? THE 75 MILLION BABY BOOMERS ACCESSING MEDICARE? THE 50 MILLION NEW ADDITIONS, ? HOW MANY MORE PCs? 32 million newly insured patients X 2 additional patients visits per year = 64 million patient visits divided by 4,000 = 16,000 additional primary care doctors Source: The Lewin Group 18
19 REFORM: CONSPICUOUS FOR WHAT IT DOES NOT DO Does not remove the cap on GME funding Just 889 new residency slots through redistribution RESIDENCY CHOKE POINT Medical School Enrollment: 18,000+ and growing Residency: 25,000 and stagnant In practice: Negative growth by 2016 Source: MGT of America 19
20 THE PHYSICIAN SHORTAGE: RESULT Health Reform throws one bucket of water on the fire and two buckets of gasoline Radiology Ophthalmology Anesthesiology Dermatology MEDICAL STUDENTS ARE TAKING THE ROAD TO SUCCESS 20
21 THE PROBLEM: MEDICAL STUDENTS ARE GOOD AT MATH Average income, Primary Care, with Medicare increases, vs. Specialists Family Practice: $178, % increase... $182,450 Internal Medicine: $205, % - 10% increase.. $215,250 - $225,500 Pediatrics: $183, % increase.. $183,000 Anesthesiology.. $335,000 Radiology..... $402,000 Cardiology (inv.).. $532,000 Dermatology... $331,000 Orthopedic Surgery... $521,000 Urology.. $453,000 Source: Merritt Hawkins 2011 Revenue of Physician Recruiting Incentives PROGRESS IS BEING MADE, BUT.. Primary physicians make 55% of what specialists make. 21
22 PHYSICIAN MALDISTRIBUTION TO CONTINUE 6,200 Health Professional Shortages Areas (HPSAs) 67% in rural areas 65 million Americans $1.5 billion over 5 years ( ) to National Health Service Corps for Loan Forgiveness 38% of MERRITT HAWKINS SEARCH ASSIGNMENTS FEATURE LOAN FORGIVENESS ED CROWDING WILL PERSIST ER visits grew 7% in Massachusetts from 2005 to 2007 PATIENTS ARE SEEKING CONVENIENT CARE RATHER THAN EMERGENCY CARE Source: CDC Emergency Department Visitors and Visits: Who Visited the ER in 2007, The Boston Globe 22
23 AGING WILL DRIVE UTILIZATION By 2030, the entire country will be as old, on average, as Florida is now. Source: U.S. Census Bureau AND THE ELDERLY WILL DRIVE POLITICS 40 million people in AARP Largest organization in the U.S., after the Catholic church 18% of U.S. population will be baby boomers by
24 WE HAVE SEEN THIS MOVIE BEFORE A TEST CASE: MASSACHUSETTS RESULT: SOURCE: *UPI, July 27, 2007 ** New York Times, April 4,
25 REFORMED MASSACHUSETTS 40% of family physicians in Massachusetts no longer accept new patients, up from 30% in Almost 60% of general internists have stopped taking new patients, up from 49% in 2007 Yet Massachusetts has 130 primary care physicians per 100,000 population, first highest in the country (the national rate is 90 per 100,000 pop.) Source: Massachusetts Medical Society Average Patient Appointment Wait Times ACCESS TO CARE WILL BE LIMITED Boston Philadelphia Los Angeles Houston Washington, D.C. San Diego Minneapolis 50 days 27 days 24 days 23 days 23 days 20 days 20 days Source: Merritt Hawkins 2009 Survey of Patient Appointment Wait Times 25
26 MEDICAID / MEDICARE PATIENTS WILL DEPEND ON SAFETY NET PROVIDERS 16+ million new Medicaid enrollees Temporary bump in physician fees WILL YOU CLOSE OR SIGNIFICANTLY RESTRICT PATIENT ACCESS TO ANY CATEGORY OF PATIENT? Medicaid.93% Medicare.87% Source: Physician Foundation 2010 Survey of Physicians and Health Reform WHO WILL SEE PATIENTS? Medicare reimbursement may fall below Medicaid levels by Medicare/Medicaid now covers 110 million people. Source: TU Health Care Maze, Richard Reece, M.D. 26
27 DOCTORS WILL VOTE WITH THEIR FEET No changes to practice... 26% Retire, cut-back, work part-time, close practice, seek non-clinical role, seek non medical job, work locum tenens, concierge, etc.. 74% They already have WILL DOCTORS REALLY CHOOSE TO LIMIT ACCESS? Hours worked per week: Equals 36,000 fewer FTEs Fewer hours strongly correlated to lower reimbursement Source: JAMA study cited in HealthLeaders, Feb 25,
28 A MESSAGE FROM AMA PRESIDENT, CECIL B. WILSON, M.D. AMA anticipates a deficiency of 125,000 physicians by will be the year of shrinking access WHAT S EMERGING? A NEW WORKFORCE PARADIGM THE CONE OF COMPLEXITY Medical specialists Primary care physicians Pharmacists (Pharm D) Advanced practice Nurses/PAs Nurse specialists Therapists LPNs Nurses aides 28
29 4 GENERATIONS OF DOCTORS Traditionalist 1945 and before Baby Boomers Gen X Gen Y Present TOMORROW S DOCTOR WILL REDEFINE THEIR ROLES Concede the less complex patients to PAs and NPs Let pharmacists help directly manage patients with chronic conditions CAVEAT: Only 37% of PAs and 67% NPs practice primary care. 29
30 THEY WILL EXPAND THEIR HOURS Practices that can arrange for patients to see a doctor or nurse after hours Netherlands 95% New Zealand 90% United Kingdom 87% Australia 81% Germany 78% Canada 47% United States 40% Source: 2006 Commonwealth Fund International Policy Survey of Primary Care Physicians OR, THEY WILL WORK PART-TIME 21% of all doctors now work part-time Hospitals and Groups must accommodate the rise of the part-time physician Source: American Medical Group Practice Association 30
31 THEY WILL EMBRACE TELEMEDICINE April, 2010, Park Nicollet rolls out online diagnosis/12 month pilot program Online diagnosis of minor problems (cold, flu, acne, bladder infections/allergies) $25 per visit PAs provide diagnosis 17 clinics for walk-in care THEY WILL BE PAID FOR EXTRACURRICULARS Telemedicine s Telephone calls Doctors will be compensated outside of the traditional billable appointment. 31
32 THEY WILL EMBRACE SAME DAY OR OPEN ACCESS SCHEDULING 15 minute rather than 10 minute appointments. Higher patient satisfaction scores THEY WILL OFFER SHARED MEDICAL APPOINTMENTS (SMAs)/ GROUP APPOINTMENTS 6 to 15 patients 90 minutes Physicals Well-child check-ups Pre-natal care Chronic illness management There is sufficient data to support the effectiveness of group visits in improving patient and physician satisfaction, quality of care, quality of life and in decreasing emergency department and specialist visits. Source: Journal of the American Board of Family Medicine 32
33 THEY WILL ALIGN WITH HOSPITALS Alignment for CEO s: Doctors who keep readmissions low, don t order too many tests 65 THEY WILL ALIGN WITH HOSPITALS Alignment for Doctors: Hospitals that let them practice medicine as they know how 66 33
34 THEY WILL ACCEPT VALUE BASED COMPENSATION Most physicians surveyed by Price Waterhouse said half their compensation should be a fixed salary. The other half should be quality, cost and production based. Source: PWC From Courtship to Marriage: A Two-Part Series on Physician-hospital alignment THE PHYSICIAN ORGANIZATION OF TOMORROW. Could well be you! Only 15% of doctors belong to the AMA 34
35 PHYSICIANS: A PRACTICE PARADIGM SHIFT: Hospital employment 56% of Merritt Hawkins searches feature employment Not just Primary Care, All specialties Only 25% of doctors could correctly identify the term cash flow Total Physician vs. Truly Independent Projected Change, (000s) % 43% 49% 57% Source: Accenture Analysis. MGMA American Medical Association 35
36 PHYSICIANS: A PRACTICE PARADIGM SHIFT: Larger groups economies of scale, strength in numbers Concierge.no more third party payors Part-time lifestyle rules Locum tenens.have Stethoscope, Will Travel Cherry picking.no Medicaid, Medicare or other low payors STANDARDIZATION Eminence Based Medicine Making the same mistakes with increasing confidence over an impressive number of years ~BMJ, Vol. 1 Sept 2001 Evidence Based Medicine Rapidly integrating individual clinical expertise with the best available external clinical evidence from systematic research. 36
37 A TECNHOLOGY SHIFT Mobile app triage Virtual visits Mobile electronics health records In-home implantable devices AND BY THE WAY. ICD 10 & HIPAA 5010 are coming 37
38 THE DOCTOR OF TOMORROW WILL. RETIRE! I m mad as hell and I m not going to take it any more HHS estimates 1/3 of today s practicing physicians (268,000 out of 815,000) will retire within the next 10 years. STAFFING PLANS MUST INCORPORATE ALL TYPES OF PHYSICIANS Employed.(over 50% of all doctors) Independent Full-time Part-time Concierge On-site Remote (telemedicine) Locum tenens Male Female International 38
39 WHERE IS MEDICAL PRACTICE HEADING? FIVE CASE HISTORIES SHOW vs. TELL 5 CASES HISTORIES A Medical Home 2 ACOs Concierge Practice or flat fee Community Health Centers Hospital Aligned Practice 39
40 THE BURDEN OF COMPLIANCE THE BURDEN OF COMPLIANCE $350 million to enforce fraud Medicare payments suspended during investigations of credible allegations of fraud HHS to define credible allegations More latitude to whistleblowers Overpayment must be repaid in 60 days Intent no longer a factor Specialty hospitals limited Encourages states to write their own Stark laws Relationships must be disclosed ALL PRACTICES NEED A COMPLIANCE PLAN 40
41 EVERYBODY HAS A PLAN, UNTIL THEY ARE PUNCHED IN THE FACE -Mike Tyson FOLLOW US Join our social community: Twitter: LinkedIn: Facebook: Text like merritthawkins to Candidate Corner Blog: Ask the Experts Blog: 41
42 If you would like a complimentary copy of the Merritt Hawkins White Paper, please contact Kurt Mosley at: Kurt.Mosley@amnhealthcare.com HEALTH REFORM AND THE DECLINE OF PHYSICIAN PRIVATE PRACTICE Presented To 42
HEALTH REFORM AND THE DECLINE OF PHYSICIAN PRIVATE PRACTICE. Presented To
HEALTH REFORM AND THE DECLINE OF PHYSICIAN PRIVATE PRACTICE Presented To BASED ON A WHITE PAPER CONDUCTED FOR: THE PHYSICIANS FOUNDATION Signatory Medical Societies: Alaska State Medical Association California
More informationAASA PHYSICIAN RECRUITING AND COMPENSATION TRENDS
AASA PHYSICIAN RECRUITING AND COMPENSATION TRENDS OUR AGENDA 1. The state of the physician workforce 2. Physician recruiting incentives and trends OUR FRAGILE, FRAGMENTED PHYSICIAN WORKFORCE PART 1 HOW
More informationTHE PHYSICIAN RECRUITING MAKEOVER: HOW TO MAKE YOUR CENTER A DOCTOR MAGNET
THE PHYSICIAN RECRUITING MAKEOVER: HOW TO MAKE YOUR CENTER A DOCTOR MAGNET THERE S AND BAD GOOD NEWS NEWS CHCs AND PHYSICIAN RECRUITING FIRST, THE BAD NEWS THE PHYSICIAN SHORTAGE IS LIKELY TO GET WORSE
More informationCHCs AND PHYSICIAN RECRUITING
THE PHYSICIAN RECRUITING MAKEOVER: HOW TO MAKE YOUR COMMUNITY HEALTH CENTER A DOCTOR MAGNET CHCs AND PHYSICIAN RECRUITING THERE S GOOD NEWS and BAD NEWS 1 FIRST, THE BAD NEWS THE PHYSICIAN SHORTAGE IS
More informationTREND WHITE PAPER LOCUM TENENS NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS: A GROWING ROLE IN A CHANGING WORKFORCE
TREND WHITE PAPER LOCUM TENENS NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS: A GROWING ROLE IN A CHANGING WORKFORCE The Leader in Locum Tenens Staffing INTRODUCTION Today s Mobile Healthcare Work Force
More informationHEALTH CARE TODAY& PHYSICIAN RECRUITING RESOURCES MICHIGAN PRIMARY CARE ASSOCIATION
HEALTH CARE TODAY& PHYSICIAN RECRUITING RESOURCES MICHIGAN PRIMARY CARE ASSOCIATION BY: JEREMY SCHULTZ SENIOR MARKET CONSULTANT 2013 AMN Healthcare, Inc. All rights reserved. Redistribution of these materials
More informationTrend The Growing Use of Locum Tenens Providers as a Supplement To Permanent Medical Staff
Trend The Growing Use of Locum Tenens Providers as a Supplement To Permanent Medical Staff By Phillip Miller Vice President of Communications Staff Care (866) 871-8519 www.staffcare.com Table of Contents
More informationA M E R I C A S PHYSICIANS. Practice Patterns & Perspectives 2014 SURVEY OF
2014 SURVEY OF A M E R I C A S PHYSICIANS Practice Patterns & Perspectives An Examination of the Professional Morale, Practice Patterns, Career Plans, and Perspectives of Today s Physicians Based on Over
More informationThe Economic Impact of Physicians
The Economic Impact of Physicians A Fact Sheet Examining the Economic Contribution Physicians Make to Their Communities and to Their Affiliated Hospitals Prepared by: Merritt Hawkins, the nation s leading
More informationSurvey of Nurse Practitioners: Practice Trends and Perspectives
Survey of Nurse Practitioners: Practice Trends and Perspectives Advanced Practice An Examination of the Professional Morale, Practice Patterns, Career Plans, and Perspectives of Nurse Practitioners Attending
More informationMEDICAL PRACTICE IN AMERICA
MEDICAL PRACTICE IN AMERICA PAST, PRESENT, AND FUTURE COULD THIS REALLY BE THE DOCTOR OF THE FUTURE? QUALCOMM FOUNDATION: THE TRICORDER X PRIZE $10 MILLION TO WHOEVER CAN CREATE A DEVICE THAT CAN DIAGNOSE
More information2014 SURVEY. Physician Appointment Wait Times and Medicaid and Medicare Acceptance Rates
SURVEY Physician Appointment Wait Times and Medicaid and Medicare Acceptance Rates A survey examining the time needed to schedule a new patient appointment with a physician in major metropolitan markets
More information. Women in Medicine: A Review of Changing Physician Demographics, Female Physicians by Specialty, State and Related Data
. Women in Medicine: A Review of Changing Physician Demographics, Female Physicians by Specialty, State and Related Data A resource provided by Staff Care, the nation s leading locum tenens staffing firm
More informationMEDICAL PRACTICE IN AMERICA
MEDICAL PRACTICE IN AMERICA PAST, PRESENT, AND FUTURE COULD THIS REALLY BE THE DOCTOR OF THE FUTURE? QUALCOMM FOUNDATION: THE TRICORDER X PRIZE $10 MILLION TO WHOEVER CAN CREATE A DEVICE THAT CAN DIAGNOSE
More informationPhysician Assistant Census Report: Results from the 2010 AAPA Census
Physician Assistant Census Report: Results from the 2010 AAPA Census PHYSICIAN ASSISTANTS AT A GLANCE: HIGHLIGHTS OF THE 2010 ANNUAL PHYSICIAN ASSISTANT CENSUS REPORT Median Age: 38 years Percent in Clinical
More informationA SURVEY OF AMERICA S PHYSICIANS: PRACTICE PATTERNS AND PERSPECTIVES
A SURVEY OF AMERICA S PHYSICIANS: PRACTICE PATTERNS AND PERSPECTIVES An Examination of the Professional Morale, Practice Patterns, Career Plans, and Healthcare Perspectives of Today s Physicians, Aggregated
More informationThe Physician Workforce. 2012 Physician Survey Report. Dianne Reynolds-Cane, MD, Director. Virginia Department of Health Professions
The Physician Workforce 2012 Physician Survey Report Dianne Reynolds-Cane, MD, Director Virginia Department of Health Professions Joint Commission on Health Care September 17, 2013 Updated 9/18/13 Healthcare
More informationAAPA ANNUAL SURVEY REPORT
2013 AAPA ANNUAL SURVEY REPORT PHYSICIAN ASSISTANTS AT A GLANCE HIGHLIGHTS OF THE MEDIAN AGE CLINICALLY PRACTICING PAS BY PRIMARY SPECIALTY PRACTICE SETTING Primary Care 32.0% Surgical Subspecialties 27.0%
More information2011 Survey of Final-Year Medical Residents
2011 Survey of Final-Year Medical Residents A Survey Examining the Career Preferences, Plans and Expectations of Physicians Completing Their Residency Training 2011 Survey of Final-Year Medical Residents
More informationTHE GROWING USE OF LOCUM TENENS DENTISTS
TREND WHITE PAPER THE GROWING USE OF LOCUM TENENS DENTISTS WE VE EARNED THE JOINT COMMISSION S GOLD SEAL OF APPROVAL The Leader in Locum Tenens Staffing IN THIS WHITE PAPER INTRODUCTION BACKGROUND: PHYSICIANS
More informationINDUSTRY PERSPECTIVES
INDUSTRY PERSPECTIVES Behavioral Health: Staying ahead of the shortage As the demand for behavioral health professionals increases, facilities should consider what implications this may have on facility
More informationCONNECTICUT MAINE. State- Specific Information Recent news, pending action:
State CONNECTICUT MAINE State- Specific Information Connecticut currently has no wide- scale programs involving telemedicine services, and Medicaid does not cover or reimburse for telemedicine. Pending
More information2013 Physician Inpatient/ Outpatient Revenue Survey
Physician Inpatient/ Outpatient Revenue Survey A survey showing net annual inpatient and outpatient revenue generated by physicians in various specialties on behalf of their affiliated hospitals Merritt
More information2009 REVIEW OF PHYSICIAN AND CRNA RECRUITING INCENTIVES
2009 REVIEW OF PHYSICIAN AND CRNA RECRUITING INCENTIVES 2009 Merritt Hawkins & Associates 5001 Statesman Drive Irving, Texas 75063 (800) 876-0500 MerrittHawkins.com SUMMARY REPORT 2009 REVIEW OF PHYSICIAN
More information2015 State Telemedicine Legislation Tracking (as of 4/28/2015) *
Alabama Alaska 2015 Telemedicine Legislation Tracking (as of 4/28/2015) * Arizona HB 2454 - Repeals telemedicine abortion prohibition; HB 2489 (STATUS: SIGNED BY GOVERNOR)- Adds some prescription drug
More informationAccountable Care Communities 101. Jennifer M. Flynn, Esq. Senior Director, State Affairs Premier healthcare alliance January 30, 2014
Accountable Care Communities 101 Jennifer M. Flynn, Esq. Senior Director, State Affairs Premier healthcare alliance January 30, 2014 Premier is the largest healthcare alliance in the U.S. Our Mission:
More informationHealth Care Section Forum
Name: Phone: Health Care Section Forum Leverage Client Feedback for Continuous Improvement Chris Franklin Executive Vice President LocumTenens.com locumtenens.com When Short Supply Meets Rapid Growth:
More informationRegulatory and Legislative Action Since the September 2010 Membership Meeting:
MEMBERSHIP MEETING January 19, 2011 Delivery System Reform: Healthcare Workforce Issue: The passage of health reform will bring millions of newly insured individuals into the system and drive patients
More informationSTATEMENT OF RECORD PRESENTED TO THE COMMITTEE ON VETERANS AFFAIRS SUBCOMMITEE ON HEALTH OVERSIGHT
STATEMENT OF RECORD PRESENTED TO THE COMMITTEE ON VETERANS AFFAIRS SUBCOMMITEE ON HEALTH OVERSIGHT HEARING ON THE ABILITY OF THE DEPARTMENT OF VETERANS AFFAIRS (VA) TO EFFECTIVELY RECRUIT, ONBOARD AND
More informationIssues in Health Care Delivery
BOARD of GOVERNORS Health Initiatives Committee Issues in Health Care Delivery Alma B. Littles, M.D. Special Advisor, STEM/Health Initiatives September 17, 2014 www.flbog.edu www.flbog.edu BOARD of GOVERNORS
More informationDecember 21, 2012. The Honorable Harry Reid Majority Leader U.S. Senate S-221 U.S. Capitol Washington, DC 20510
December 21, 2012 The Honorable Harry Reid Majority Leader U.S. Senate S-221 U.S. Capitol Washington, DC 20510 The Honorable Mitch McConnell Republican Leader U.S. Senate S-230 U.S. Capitol Washington,
More information2014 Trends in Temporary Physician Staffing Trends
WE VE EARNED THE JOINT COMMISSION S GOLD SEAL OF APPROVAL 2014 SURVEY OF TEMPORARY PHYSICIAN STAFFING TRENDS BASED ON DATA 2014 STAFF CARE, Inc 5001 Statesman Drive, Irving, Texas 75063 (800) 685-2272
More informationSummary of results from a clinical doctorate survey
Summary of results from a clinical doctorate survey Survey was conducted on-line using SurveyMonkey Survey was announced on February 23 via special AAPA e-news and link was posted on AAPA and PAEA web
More information2015 SURVEY OF TEMPORARY PHYSICIAN STAFFING TRENDS BASED ON 2014 DATA
CERTIFIED BY THE JOINT COMMISSION AND THE TIOL COMMITTEE FOR QUALITY ASSURANCE 2015 SURVEY OF TEMPORARY PHYSICIAN STAFFING TRENDS BASED ON DATA 2015 Staff Care, Inc 5001 Statesman Drive, Irving, Texas
More information2014 Statistical Profile of Certified Physician Assistants
2014 Statistical Profile of Certified Physician Assistants An Annual Report of the National Commission on Certification of Physician Assistants NCCPA. 2015. All rights reserved. 1 Message from the President/CEO
More informationTHE DOCTOR CAN T SEE YOU NOW NEW YORK S PHYSICIAN SHORTAGE GROWS
THE DOCTOR CAN T SEE YOU NOW NEW YORK S PHYSICIAN SHORTAGE GROWS DECEMBER 2009 KEY FINDINGS HANYS 2009 Physician Advocacy Survey Physician retirements are offsetting recruitment, and little progress is
More informationFILLING THE. reported by. continue...
FILLING THE 2013 Physician Outlook & PRACTICE TRENDS reported by continue... OVERVIEW Physician discontent appears to be creating a void in the healthcare field. Physicians are preparing to leave medicine
More informationThe Health Insurance Marketplace 101
The Health Insurance Marketplace 101 National Newspaper Association 127th Annual Convention & Trade Show September 13, 2013 Office of the Regional Director Community Resource California-Based Arizona,
More informationPsychiatry: The Silent Shortage
Psychiatry: The Silent Shortage A resource provided by Merritt Hawkins, the nation s leading physician search and consulting firm and a company of AMN Healthcare (NYSE: AHS), the largest healthcare workforce
More informationTotal 15,555 191,604
January 2012 Program -to -Date Medicare Eligible Professionals 8,524 132,445 Doctors of Medicine or Osteopathy 7,620 118,146 Dentists 12 198 Optometrists 436 5,928 Podiatrists 222 4,890 Chiropractors 234
More informationTraining Physicians in Geriatric Care: Responding to Critical Need
Training Physicians in Geriatric Care: Responding to Critical Need Greg O Neill Patricia P. Barry As the nation s older population grows, the U.S. will require a well-trained workforce of health care providers
More informationWorkforce Development Programs
Nurses provide extraordinary care. They re the front lines of the healthcare system. ~ President Barack Obama White House Health Care Summit March 5, 2009 Nursing Workforce Development Programs Title VIII
More informationDavid Ramos, MD, MPH, FACC Managing Physician ColumbiaDoctors of the Hudson Valley
David Ramos, MD, MPH, FACC Managing Physician ColumbiaDoctors of the Hudson Valley The Changing Landscape of Medicine Changing Culture Demographics Income Terms and definitions RVUs, Restricted Covenants,
More informationdirection in the midst of uncertainty SCMA Presentation 2012
direction in the midst of uncertainty SCMA Presentation 2012 so where are we? force #1: the affordable care act STRATEGIC DIRECTIONS OF Coverage Delivery system reforms Payment reforms Transparency Health
More informationAn Internist s Practical Guide to Understanding Health System Reform
An Internist s Practical Guide to Understanding Health System Reform Prepared by: ACP s Division of Governmental Affairs and Public Policy Updated October 2013 How to cite this guide: American College
More informationINDUSTRY PERSPECTIVES. Knowing your demographic: Exploring the utilization of locums physicians to expand business
INDUSTRY PERSPECTIVES Knowing your demographic: Exploring the utilization of locums physicians to expand business Justin Roark, Recruiting Principal, Delta Locum Tenens the Offering services appropriate
More information2013 Survey of Temporary. 2013 STAFF CARE, Inc. 5001 Statesman Drive, Irving, Texas 75063 (800) 685-2272 www.staffcare.com
We ve earned The Joint Commission s Gold Seal of Approval 2013 Survey of Temporary Physician Staffing Trends Certified by the Joint Commission 2013 STAFF CARE, Inc 5001 Statesman Drive, Irving, Texas 75063
More informationRURAL NURSE PRACTITIONERS: RHAC SURVEY RESULTS. Presentation to Rural Health Advisory Committee & Flex Committee May 19, 2015
RURAL NURSE PRACTITIONERS: RHAC SURVEY RESULTS Presentation to Rural Health Advisory Committee & Flex Committee May 19, 2015 Review: Minnesota regions Review: NPs vs population, by Minnesota region 2015
More informationA Journey to Improve Canada s Healthcare System
A Journey to Improve Canada s Healthcare System The Quest Can a public/private hospital system coexist and thrive and improve Canada s system? The Journey Visited Australia and New Zealand to find out
More informationMedicaid Topics Impact of Medicare Dual Eligibles Stephen Wilhide, Consultant
Medicaid Topics Impact of Medicare Dual Eligibles Stephen Wilhide, Consultant Issue Summary The term dual eligible refers to the almost 7.5 milion low-income older individuals or younger persons with disabilities
More informationMarch 5, 2014. The Honorable Harry Reid Majority Leader U.S. Senate S-221 U.S. Capitol Building Washington, DC 20510
March 5, 2014 The Honorable Harry Reid Majority Leader U.S. Senate S-221 U.S. Capitol Building Washington, DC 20510 The Honorable Mitch McConnell Republican Leader U.S. Senate S-230 U.S. Capitol Washington,
More informationMedicare- Medicaid Enrollee State Profile
Medicare- Medicaid Enrollee State Profile The National Summary Centers for Medicare & Medicaid Services Introduction... 1 Data Source and General Notes... 2 Types and Ages of Medicare-Medicaid Enrollees...
More information2011 State Physician Workforce Data Book
Center for Workforce Studies November 2011 Association of American Medical Colleges Association of American Medical Colleges 2009 Acknowledgments The 2011 State Physician Workforce Data Book was produced
More informationHow States Will Solve the Healthcare Workforce Crisis: What to ask for from the Feds. Robert Phillips MD MSPH The Robert Graham Center
How States Will Solve the Healthcare Workforce Crisis: What to ask for from the Feds Robert Phillips MD MSPH The Robert Graham Center Agenda Healthcare Reform about the Economy this time Primary Care seen
More informationTO: FROM: DATE: RE: Mid-Year Updates Note: NCQA Benchmarks & Thresholds 2014
TO: Interested Organizations FROM: Patrick Dahill, Assistant Vice President, Policy DATE: July 25, 2014 RE: 2014 Accreditation Benchmarks and Thresholds Mid-Year Update This document reports national benchmarks
More informationUtah Telehealth Study Summary Report. Prepared by Pilot Healthcare Strategies for the Utah Division of Occupational and Professional Licensing
Utah Telehealth Study Summary Report Prepared by Pilot Healthcare Strategies for the Utah Division of Occupational and Professional Licensing June 24, 2014 Top line observations As this report was being
More informationUnderstanding and preparing for the impact of the Affordable Care Act
Understanding and preparing for the impact of the Affordable Care Act Care Management / P. 1 The Affordable Care Act is expected to impact access to care, change the way accountable care organizations
More informationPrimary Care Recruitment & Retention Programs in Massachusetts
Primary Care Recruitment & Retention Programs in Massachusetts Nicole Watson Recruitment / Retention Program Specialist, Massachusetts Health Care Workforce Center Nicole.watson@state.ma.us The Massachusetts
More informationEverything You Thought You Knew About the Physician Shortage: The Specialty (Neurosurgical) Perspective
Everything You Thought You Knew About the Physician Shortage: The Specialty (Neurosurgical) Perspective Presented by: H. Hunt Batjer, MD Darwin E. Smith Distinguished Chair in Neurological Surgery, The
More informationTexas State Government Effectiveness and Efficiency APRN Prescriptive Authority & Recommendations
Texas State Government Effectiveness and Efficiency APRN Prescriptive Authority & Recommendations SUBMITTED TO THE 82ND TEXAS LEGISLATURE JANUARY 2011 LEGISLATIVE BUDGET BOARD STAFF INCREASE ACCESS TO
More information3/28/2014. Spencer Berthelsen, M.D. Texas Club of Internists
Spencer Berthelsen, M.D. Texas Club of Internists April 4, 2014 Cost The US spends twice as much per capita as the average of other industrialized nations Institute of Medicine 30% of healthcare dollars
More informationHealthcare. State Report. Anthony P. Carnevale Nicole Smith Artem Gulish Bennett H. Beach. June 2012
Healthcare State Report June 2012 Anthony P. Carnevale Nicole Smith Artem Gulish Bennett H. Beach B Table of Contents Healthcare: State Level Analysis... 3 Alabama... 12 Alaska... 14 Arizona... 16 Arkansas...
More informationSummary of the State Elder Abuse. Questionnaire for Illinois
Summary of the State Elder Abuse Questionnaire for Illinois A Final Report to: Illinois Department on Aging February 2002 Prepared by Researchers at The University of Iowa Department of Family Medicine
More informationMEDICAL PRACTICE IN AMERICA
MEDICAL PRACTICE IN AMERICA PAST, PRESENT, AND FUTURE COULD THIS REALLY BE THE DOCTOR OF THE FUTURE? QUALCOMM FOUNDATION: THE TRICORDER X PRIZE $10 MILLION TO WHOEVER CAN CREATE A DEVICE THAT CAN DIAGNOSE
More informationThe Looming Doctor Shortage. Are these scenarios possible or even probable? History of Physician Education in the United States
Policy Note The Looming Doctor Shortage by Dr. Roger Stark, MD, FACS Health Care Policy Analyst November 2011 Key Findings 1. The aging of the baby boomer generation, plus the 32 million people newly insured
More information2015 Year Over Year HEALTHCARE JOBS SNAPSHOT. A quarterly report produced by Health ecareers
2015 Year Over Year HEALTHCARE JOBS SNAPSHOT A quarterly report produced by Health ecareers TABLE of CONTENTS Executive Summary 3 Key Findings General Findings 4 Physicians/Surgeons 5 Nurses, Nurse Practitioners
More information2013 SURVEY OF TEMPORARY PHYSICIAN STAFFING TRENDS. 2013 STAFF CARE, Inc. 5001 Statesman Drive, Irving, Texas 75063 (800) 685-2272 www.staffcare.
We ve earned The Joint Commission s Gold Seal of Approval 2013 SURVEY OF TEMPORARY PHYSICIAN STAFFING TRENDS 2013 STAFF CARE, Inc 5001 Statesman Drive, Irving, Texas 75063 (800) 685-2272 www.staffcare.com
More informationThe Patient Protection and Affordable Care Act. Implementation Timeline
The Patient Protection and Affordable Care Act Implementation Timeline 2009 Credit to Encourage Investment in New Therapies: A two year temporary credit subject to an overall cap of $1 billion to encourage
More informationSummary of the State Elder Abuse. Questionnaire for Connecticut
Summary of the State Elder Abuse Questionnaire for Connecticut A Final Report to: Department of Social Services February 2002 Prepared by Researchers at The University of Iowa Department of Family Medicine
More informationHPNEC. FY 2015 Brochure
HPNEC Health Professions and Nursing Education COALITION Health Professions Education Programs: Connecting students to health careers, health professionals to underserved communities, and communities to
More informationMarch 28, 2012. Dear Acting Administrator Tavenner:
March 28, 2012 Marilyn B. Tavenner Acting Administrator U.S. Department of Health and Human Services Hubert H. Humphrey Building, Room 445-G 200 Independence Avenue, SW Washington, DC 20201 Dear Acting
More informationSummary of the State Elder Abuse. Questionnaire for Vermont
Summary of the State Elder Abuse Questionnaire for Vermont A Final Report to: Vermont Adult Protective Services February 2002 Prepared by Researchers at The University of Iowa Department of Family Medicine
More informationNEW YORK S GROWING DEMAND
Nurses and Allied Health Professionals NEW YORK S GROWING DEMAND Results from the 2011 Health Care Professionals Workforce Survey JUNE 2011 Published by The 2011 Health Care Professionals Workforce Survey
More informationACTIVITY DISCLAIMER. Negotiating an Employment Contract that Ensures Success Under Value-based Payment
Negotiating an Employment Contract that Ensures Success Under Value-based Payment Travis Singleton ACTIVITY DISCLAIMER The material presented here is being made available by the American Academy of Family
More informationPhysician Assistants: Collaboration/Supervision, Ratios, Prescribing. Physician Meeting Required
Assistants: /Supervision, Ratios, Prescribing Jurisdiction w/ Agreement & Alabama Yes Yes registration approved by the board Alaska Yes Yes collaborative plan filed with department Once a week if PA performs
More informationCITY AVERAGE NUMBER OF DAYS WAIT FOR APPOINTMENTS (2009) CARDIOLOGY DERMATOLOGY OB/GYN
TITLE Reduce Patient Wait Times Before it s TOO LATE! ABSTRACT Patient wait times are a strong predictor of overall satisfaction, and central to the Care Experience component of the Triple Aim initiative
More informationAnd in rural areas. Chart 3: Median number of days to fill vacant RN positions in urban and rural areas
RN Shortages in Hospitals March 1999, Vol. 1, No. 2 Nurses comprise the largest sector of the healthcare workforce and the majority of nurses work in hospitals. Because of the prominence and importance
More informationNational and State-Level Projections of Dentists and Dental Hygienists in the U.S., 2012-2025 February 2015
National and State-Level Projections of Dentists and Dental Hygienists in the U.S., 2012-2025 February 2015 U.S. Department of Health and Human Services Health Resources and Services Administration Bureau
More informationNursing and Health Reform
Nursing and Health Reform The Patient Protection and Affordable Care Act (PPACA) was signed into law by President Obama on March 23, 2010. This law will enact sweeping changes to almost every facet of
More informationHealth Professions Programs:
Health Professions Programs: Investing in tomorrow s workforce. Improving health. FY 2011 Brochure The Health Professions and Nursing Education Coalition (HPNEC) is an alliance of over 60 national organizations
More informationMGMA ACA Exchange Implementation Survey Report. May 2014
MGMA ACA Exchange Implementation Survey Report May 2014 Overview Medical Group Management Association (MGMA) conducted member research in April 2014 to better understand the impact of the Affordable Care
More informationEconomic Impact and Variation in Costs to Provide Community Pharmacy Services
Economic Impact and Variation in Costs to Provide Community Pharmacy Services Todd Brown MHP, R.Ph. Associate Clinical Specialist and Vice Chair Department of Pharmacy Practice School of Pharmacy Northeastern
More informationThe Affordable Care Act
The Affordable Care Act What does it mean for internists? Joshua Becker MD 10/14/2015 VII. 2015 Reforms and Beyond Payment Penalties under Medicare s Pay-for-Reporting Program Value-Based Payment Modifier
More informationAbout MGMA. Our mission To continually improve the performance of medical group practice professionals and the organizations they represent
About MGMA Our mission To continually improve the performance of medical group practice professionals and the organizations they represent Impact of Healthcare Reform on Pediatric Practices William F.
More informationFeel Better...Faster. 2014 AmeriDoc, LLC 14785 Preston e 975 Dallas, TX 75254 1-866-747-6899 www.ameridoc.com
Feel Better...Faster 2014 AmeriDoc, LLC 14785 Preston e 975 Dallas, TX 75254 1-866-747-6899 www.ameridoc.com We Are WWW.AMERIDOC.COM PAGE 2 AmeriDoc is a leading provider of 24/7/365 on-demand healthcare
More informationThe Healthcare Workforce Shortage and Its Implications for America s Hospitals. Fall 2001
The Healthcare Workforce Shortage and Its Implications for America s Hospitals Fall 2001 2 This report was produced by First Consulting Group and Commissioned by: The American Hospital Association The
More informationSummary of the State Elder Abuse. Questionnaire for Ohio
Summary of the State Elder Abuse Questionnaire for Ohio A Final Report to: Department of Human Services February 2002 Prepared by Researchers at The University of Iowa Department of Family Medicine 2 Grant,
More informationGAO NURSING WORKFORCE. Emerging Nurse Shortages Due to Multiple Factors
GAO United States General Accounting Office Report to the Chairman, Subcommittee on Health, Committee on Ways and Means, House of Representatives July 2001 NURSING WORKFORCE Emerging Nurse Shortages Due
More informationSummary of the State Elder Abuse. Questionnaire for Georgia
1 Summary of the State Elder Abuse Questionnaire for Georgia A Final Report to: Department of Human Resources Office of Adult Services February 2002 Prepared by Researchers at The University of Iowa Department
More informationChanges in the Cost of Medicare Prescription Drug Plans, 2007-2008
Issue Brief November 2007 Changes in the Cost of Medicare Prescription Drug Plans, 2007-2008 BY JOSHUA LANIER AND DEAN BAKER* The average premium for Medicare Part D prescription drug plans rose by 24.5
More informationPrimary Care Physician Scan in Georgia: 2014
Primary Care Physician Scan in Georgia: 2014 RECRUITMENT, RETENTION, AND COORDINATION Physician To Population Ratio Primary Care Physician Supply Georgia s Medical Workforce: Geographic 159 Counties:
More informationTelemedicine and Telehealth in Context. Jonathan Neufeld, PhD Clinical Director Upper Midwest Telehealth Resource Center
Telemedicine and Telehealth in Context Jonathan Neufeld, PhD Clinical Director Upper Midwest Telehealth Resource Center 1 Definitions and Concepts Telehealth and Telemedicine Sometimes used interchangeably
More informationWorkforce Development Programs
Nurses provide extraordinary care. They re the front lines of the healthcare system. ~ President Barack Obama White House Health Care Summit March 5, 2009 Nursing Workforce Development Programs Title VIII
More informationHow Health Reform Will Affect Health Care Quality and the Delivery of Services
Fact Sheet AARP Public Policy Institute How Health Reform Will Affect Health Care Quality and the Delivery of Services The recently enacted Affordable Care Act contains provisions to improve health care
More informationSummary of the State Elder Abuse. Questionnaire for Alabama
Summary of the State Elder Abuse Questionnaire for Alabama A Final Report to: Department of Human Resources Office of Adult Services February 2002 Prepared by Researchers at The University of Iowa Department
More informationACCESS TO CARE IN CRISIS: PHYSICIANS IN SHORT SUPPLY
HANYS ACCESS TO CARE IN CRISIS: PHYSICIANS IN SHORT SUPPLY HANYS 2008 PHYSICIAN WORKFORCE SURVEY NOVEMBER 2008 ACCESS TO CARE IN CRISIS: PHYSICIANS IN SHORT SUPPLY HANYS 2008 PHYSICIAN WORKFORCE SURVEY
More informationNursing Workforce. Primary Care Workforce
Key Provisions Related to Nursing: The Patient Protection and Affordable Care Act (Public Law 111-148) clearly represents a movement toward much-needed, comprehensive and meaningful reform for our nation
More informationPHYSICIAN AND NURSE SUPPLY: THE MISSING PIECE OF THE PUZZLE
PHYSICIAN AND NURSE SUPPLY: THE MISSING PIECE OF THE PUZZLE A Review of the Presidential Candidates Healthcare Reform Proposals In the Context of Physician and Nurse Supply 12400 High Bluff Drive San Diego,
More information2013 State Physician Workforce Data Book
Center for Workforce Studies November 2013 Association of American Medical Colleges Association of American Medical Colleges 2009 Acknowledgments The 2013 State Physician Workforce Data Book was produced
More information