A recent report detailing physician shortages in Maryland is flawed and misleading, according to representatives from CareFirst BlueCross BlueShield. Rather than a shortage, Maryland enjoys an adequate supply of physicians, fourth best in the United States, said Henry Miller, who represented CareFirst during a meeting of a state healthcare panel. Miller then came under fire by members of the Maryland Governor's Task Force on Health Care Access and Reimbursement for his assessment.
Silver Spring, MD-based Holy Cross Hospital's Ethnic Health Promotion Program tries to mitigate the health problems facing immigrants by having health educators, including foreign-educated doctors, help them. Through the program, preventitive health is taught in the immigrants' languages and in the context of their various cultures.
The 12 new physicians at St. Francis Medical Center in Grand Island, NE, are due at least in part to the opening of the a new patient tower addition, said hospital President and CEO Mike Gloor. The tower serves as a "big billboard" for the hospital, as it can be seen by many who travel local highways and main thoroughfares, Gloor said.
In this opinion piece from the Seattle Post-Intelligencer, Jeff Huebner, MD, and Rupin Thakkar, MD, say banning data mining would protect the patient-physician relationship, control escalating healthcare costs and reduce inappropriate prescribing.
To successfully market a medical group practice, you must begin by assessing your strengths, weakness, and opportunities. The problem is, many practices don't know their markets as well as they should. 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 percent of its referred patients?
Much of this information is available through secondary market research-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 can also come from 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.
Don't let the wails of disapproval fool you; healthcare groups were not caught off guard by President Bush's budget proposal that would slash some $560 billion from Medicare over the next decade, according to the Wall Street Journal.
But seeing trouble on the way doesn't always help. Last fall at the annual MGMA conference I talked with William Jessee, MD, about the continual decline in reimbursement. With so many private payers piggybacking their rates on these dwindling Medicare rates and some 47 million uninsured, the financial outlook for medical groups appears bleak.
And don't discount the impact of the cost of running a practice, says Jessee. He points out that, according to the MGMA, Medicare reimbursement for 2008 is expected to decline by 1.7 percent compared to 1999, but operating costs have increased by 62 percent over that time.
"When your costs are going up 62 percent and your revenue is going down 1 percent, something's got to give," he says.
Indeed. Unfortunately what's giving might just be the number of qualified people willing to practice medicine in such an unfriendly economic environment.
As the AMA stated prior to last week's State of the Union Address, without Congressional action, physicians face a significant payment cut from Medicare this July. And a survey of members found that 60 percent of physicians would limit the number of new Medicare patients they can treat if the 10 percent cut occurs. We've seen reports like this one in the past, and Congress has come to the rescue.
The AHA was also very critical of the president's plan, saying it would have a disastrous effect on America's healthcare system. In a prepared statement, the AHA's Rich Umbdenstock says, "At a time when physicians are in short supply, this budget calls for cuts to teaching hospitals that prepare tomorrow's physicians. At a time when our economy is faltering, this budget cuts hospitals serving some of America's poorest patients. At a time when an aging America depends on modern hospital care, this budget drastically reduces funds that help hospitals keep cutting-edge technology available for communities. This budget cuts programs that help rural communities keep their healthcare, train the nurses and caregivers of tomorrow, and assist children's hospitals in training pediatricians and other specialists."
Clearly, the Bush administration is aware of the basic principles of inflation--at least when it comes to its defense budget. After all, it has increased military spending by about 30 percent since Bush came to office, even as funding for so-called entitlement programs heads downward. A White House fact sheet says cuts to Medicare and Medicaid would save $208 billion over five years and the alternative would be "massive tax increases, sudden and drastic cuts in benefits, or crippling deficits."
Scary stuff--but not nearly as frightening as the prospects of the inevitable shortfall of physicians we face and the likelihood that those we have will be hard-pressed to accept Medicare patients.
So now healthcare lobbyists will descend on Congress to right the executive office's bloated--to the record tune of $3.1 trillion--and slipshod federal budget. But I'm expecting Congressional revisions that amount to Band-Aids where sutures are needed.