A few years ago, executives at the University of Chicago Medical Center were concerned that an increasing number of patients were arriving at their emergency room with what the executives considered to be non-urgent complaints. Michelle Obama, an executive at the medical center, launched a program to steer the patients to existing neighborhood clinics. That effort inspired a broader program the hospital now calls its Urban Health Initiative. To ensure community support, Michelle Obama and others recommended that the hospital hire the firm of David Axelrod, who a few months later became the chief strategist for Barack Obama's presidential campaign. The medical center's initiative illustrates how the Obamas, their associates at the University of Chicago, and Axelrod, dealt with an intractable social problem that confronts many urban areas: How much care should large, nonprofit hospitals offer the poor in return for tax-exempt status?
The residency program at Des Moines, IA-based Broadlawns Medical Center offers a training ground for family doctors as both Iowa and the country faces a critical shortage in family medicine. Participants in Broadlawns' program encounter a diverse population with a wide range of healthcare needs, said Larry Severidt, director of medical education and the family medicine residency program at Broadlawns. The focus is to provide doctors with intense training in a broad base of skills, and if these doctors work in rural areas they'll know how to deliver babies, how to care for critical patients, how to manage an emergency room, and more, Severidt said.
A growing number of Minnesota doctors are trying to reassert their independence by breaking away from the larger groups and starting their own practices. Some of these physicians are offering "concierge care," where a limited number of patients pay a membership fee for 24-hour access to a physician. These experiments speak to a hankering for the personal relationship that is sometimes lost between doctor and patient, according to this article in the Minneapolis Star-Tribune.
In 2007, 56% of American adults sought information about a personal health concern, up from 38% in 2001, according to a study by the Center for Studying Health System Change. Use of all information sources rose substantially, with Internet information seeking doubling to 32% during the six-year period. Consumers across all categories of age, education, income, race/ethnicity and health status increased their information seeking significantly, but education level remained the key factor in explaining how likely people are to seek health information, according to the study.
The Centers for Medicare & Medicaid Services has announced that all physician groups participating in the Physician Group Practice Demonstration improved the quality of care delivered to patients with congestive heart failure, coronary artery disease, and diabetes mellitus during performance year two of the demonstration.
The 10 groups earned $16.7 million in incentive payments under the demonstration that rewards healthcare providers for improving health outcomes and coordinating the overall healthcare needs of Medicare patients assigned to the groups, according to a CMS release.
It is crucial to know the characteristics of your practice's service area. Start by asking basic questions about the service area, including the following:
Is the population growing or declining?
What trends are you seeing with respect to the average age, sex, household income, race/ethnicity mix, education levels, and length of residence?
Describe the work force: Is there a predominant employer?
What is the mix of retail, manufacturing, governmental, and service occupations?
What potential effect will environmental factors have on the community's physical and mental health?
Who are your competitors? How many similar physician practices serve the same population?
What is the distribution of primary care versus specialty care physicians in the service area?
Do consumers out-migrate from the service area for specialty care, and if so, why?
How do consumers/patients differentiate physician care delivered at your medical practice from what is offered at competitor practices?
What attributes do they value that can be leveraged to build awareness, preference, and, ultimately, utilization of your group's service offerings?
How do consumers perceive the physician group?
Is there anything truly distinctive and meaningful about the group, and if so, how is this being communicated to the marketplace?
What sources do consumers rely upon to get information about physicians and the group's clinical offerings?
How do consumers make their choices about where to go for care (e.g., health plan, employer, word of mouth, etc.)?
From where does the practice draw 80% of its referred patients?
Much of this information is available through secondary market research, which refers to already existing information obtained from external sources, such as the Medical Group Management Association, the U.S. Census Bureau, and local and state medical associations. It also includes internally generated data, such as relative value units, current procedural terminology codes, and patients' ZIP codes.
Unlike hospitals, which have access to standardized inpatient market share reports, most medical groups don't have a lot of detailed information about their market share and must rely on estimates. The National Ambulatory Medical Care Survey publishes physician visits by specialty every two years. However, this information is specific to regions of the country and not to local area marketplaces.
There also are proprietary outpatient modeling software packages that estimate office visits using claims-based data. These may be a better solution, depending on your needs. The important thing is to recognize trends and to know what is happening in the practice service area. Choose the method that best helps you do this.