In addition, physician practices that have been dependent on ancillary revenues to support physician compensation are being negatively impacted by reimbursement changes, says Hickman. These practices, such as cardiology and oncology groups, are looking at how they can realign with healthcare systems.
"We need to reorganize ourselves in a way to really tackle community health from a quality, cost, and efficiency perspective," says Stephen Moore, MD, senior vice president and chief medical officer (CMO) at Catholic Health Initiatives (CHI).
To that end, CHI, a nonprofit health system with 73 hospitals and 40 long-term care, assisted- and residential-living facilities, announced in March the appointment of T. Clifford Deveny, MD, to the newly created position of senior vice president of physician practice management. The Englewood, CO-based organization's goal is to significantly expand the number of employed physicians from approximately 1,500 to more than 3,000 in the next two to three years.
"We need to have a secure base of physicians from an employment perspective as well as a cadre of community doctors through other contractual arrangements in order for us to align all the incentives from a regulatory to legal and compliance standpoint," Moore says.
The health system plans on having 65% of its net patient service revenue come from outside the acute care hospital and be able to fully manage the risk of community populations-with the help of data analysis tools-by 2020.
Small physician practice gives up the reins
Endocrinologist Karl David McCowen, MD, founded Tacoma, WA-based Endocrine Consultants Northwest in 1980 and became part of Franciscan Medical Group (FMG) nearly 30 years later in 2009. There was a perfect storm of conditions that led the practice, which included three endocrinologists and one nurse practitioner, to seek employment, McCowen says-namely, the diabetes epidemic, difficulty recruiting, and pressure to adopt EMRs.