Independent Docs Paid Less than Employed Docs
Independent physicians are struggling to find equal footing with employed doctors, as they’re often reimbursed notably less than their hospital- or health system-affiliated counterparts, according to a new survey. In its 2016 Fee Schedule Survey, Physicians Practice found that doctors affiliated with a hospital or health network are paid about $74 on average for office visits coded for new patients, while independent doctors are paid about an average of $58.40. Click here for more.
Co-Owner | Co-Founder | CEO at PHAS Physician Hospital Administrative Solutions LLC
8 年There seems to be an inversion of sorts that makes more strategic sense than sense of fairness. Employed physician groups tend to have more negotiating leverage to up their reimbursement yet independents tend to treat upwards of 25% more volume. As a system it's necessary to provide income guarantees to entice employment. Once "owned", volume hurdles are typically too high to encourage increased effort while at little guaranteed compensation risk for falling below. Integrated markets designed to create collaborative efficacy tend to stifle provider capacity in already underserved markets. Hospitals wind up subsidizing support that was more economically gained via hosting independent providers who now no longer retain their own: support, contracting , or practice autonomy while under non-compete onus in the market they've established. Competition is healthy until we look like Siamese twins in a knife fight.
President - The O'Sullivan Group, Inc
8 年Health Plans don't care at all about this. They all pay about the same rates to independent physicians and they all pay about the same to hospital employed physicians. For them its a level playing field in terms of premium. However for employers and individuals who purchase insurance, particularly those with high deductibles it is very important. The status quo is failing consumers. Independent providers wanting to stay independent need to develop direct to consumer cash pay pricing that is understandable and affordable.
A great example of why provider based reimbursement needs to be sunsetted. The same doctor, once employed, has a larger per unit reimbursement ( but likely not a higher per unit compensation). The difference goes to "overhead " at their employer. All of us are paying for this in the form of higher rates.