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AMA Updated Data on Physician Practice Arrangements

Data from the American Medical Association’s Physician Practice Benchmark Surveys indicates for the first time ever that more physicians are employees rather than owners of medical practices. Physician employment has been an ongoing trend in recent years, but the AMA report indicates the pace of growth has slowed.

This latest report provides data and discussion of medical practices, covering their number, type, size, specialty, and ownership structure.

Source: Kane CK. Policy research perspectives. Updated data on physician practice arrangements: for the first time, fewer physicians are owners than employees. American Medical Association, 2019. https://www.ama-assn.org/system/files/2019-07/prp-fewer-owners-benchmark-survey-2018.pdf 

Posted by AHA Resource Center, (312) 422-2050, rc@aha.org

 

DISRUPTORS: Redesigning patient care in a ‘facilitated self-service’ model – the bot, the nurse, the PCP

Facilitated self-service means consumers can handle most of their needs without help, but some needs require a higher level of service.

How to redesign care at the physician office visit level is discussed in this brief perspective.  In the facilitated self-service model, patients might first encounter a bot for routine check-ups of chronic conditions.  The second level of care would be the nurse and the third level, the physician, if needed.  The authors maintain that this radically different approach would be better than trying to expand the numbers and availability of primary care physicians for routine care.

Source: Asch, D.A., Nicholson, S., and Berger, M.L. (2019, May 16). Toward facilitated self-service in health care.  New England Journal of Medicine, 380(20), 1891-1893.  Click here for full text (you can sign up as a visitor for 3 full text articles per month):  https://www.nejm.org/toc/nejm/medical-journal?query=main_nav_lgPosted by AHA Resource Center (312) 422-2050 rc@aha.org

FORECASTING: Discharges to decline 2 percent in 10 years

Our analytics are projecting a 2 percent decline in discharges over the next decade.  As a result, clients are challenging their perceived acute care footprint needs and increasingly reallocating resources to a variety of outpatient and virtual settings.”  Sg2

I always like to grab consultants’ forecasts – about nearly anything! – and feature them here.  However, it is doubly interesting when the forecasts are about hospital inpatient utilization.  This little snippet from Sg2 is part of an interesting conglomeration of opinion about the hospital of the future.   Becker’s Hospital Review interviewed 45 leaders with an interesting mix of affiliations – providers, consultants, vendors – about disruptors affecting the hospital field.

Source: Dyrda, L. (2017, July 17). 45 hospital and healthcare executives outline the hospital of the future. Becker’s Hospital Review.  Click here: https://www.beckershospitalreview.com/hospital-management-administration/45-hospital-and-healthcare-executives-outline-the-hospital-of-the-future.html  Posted by AHA Resource Center (312) 422-2003, rc@aha.org

OBSTETRICS: C-section rate expected to be 27 to 30 percent

The rate of cesarean deliveries is currently around one-third of all deliveries in the U.S. and is expected to remain in the range of 27 to 30 percent for the near term.  In about 15 years, the rate may drop to 20 to 25 percent.  Factors responsible for the continued “upward pressure” on the C-section rate include maternal age, obesity and diabetes.

Source: Clapp, M.A., and Barth, W.H., Jr. (2017, December). The future of cesarean delivery rates in the United States. Clinical Obstetrics & Gynecology, 60(4), 829-839.  Click here for publisher’s website: http://journals.lww.com/clinicalobgyn/Abstract/2017/12000/The_Future_of_Cesarean_Delivery_Rates_in_the.17.aspx  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

FORECASTING: How to predict closure of rural hospitals

From January 2010 to December 2015, 63 rural hospitals closed, and over 1.7 million people are now at greater risk of negative health and economic hardship due to the loss of local acute care services.”

A model to predict financial distress and the risk of closure for rural hospitals is described in this scholarly article out of the Cecil G. Sheps Center for Health Services Research at the University of North Carolina.  The model was validated in that all of the selected financial performance indicators were found to be associated with the likelihood of hospital financial problems.  A surprise was that investor-owned rural hospitals were found to be more likely than expected to be in financial distress; although, this might be linked to their tendency to be located in southern states, which – as a region – are more likely to be struggling financially.

Source: Holmes, G.M., Kaufman, B.G., and Pink, G.H. (2017, Summer). Predicting financial distress and closure in rural hospitals. Journal of Rural Health, 33(3), 239-249.  Click here for access to the publisher’s website: http://onlinelibrary.wiley.com/doi/10.1111/jrh.12187/pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

 

POPULATION HEALTH: How many diabetics in 2030?

The team finds that in spite of medical advances and prevention efforts, diabetes presents a major health crisis in terms of prevalence, morbidity, and costs, and that this crisis will worsen significantly over the next 15 years.

An estimated 54.9 million people will have diabetes in the U.S. in the year 2030, compared to 35.6 million in 2015, according this study from the Institute for Alternative Futures.  This represents a 54 percent increase.  The prevalence of diabetes will represent a cost to the nation of over $622 billion in 2030 (calculated in 2015 dollars), up from roughly $408 billion in 2015.  Maps included in the article show some clustering projected for 2030 – states with higher proportions of diabetics are in the southeast, southwest, and Rust Belt regions.

Source: Rowley, W.R., and others. (2017, February). Diabetes 2030: Insights from yesterday, today, and future trends. Population Health, 20(1), 6-12.  Click here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5278808/pdf/pop.2015.0181.pdf.  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

Number of System-Affiliated vs Independent Community Hospitals, 1999-2015

System-affiliated hospitals outnumber those that remain independent. In 2015, 66% of community [acute care, non-federal] hospitals were affiliated with a health care system. This compares to 51% in 1999. Conversely, 34% of community hospitals were independent facilities in 2015, down from 49% in 1999.system-vs-nonsystem-comm-hosp-fy15

 system-vs-nonsystem-comm-hosp-fy15-chart

Sources:

Fast facts on US hospitals: pie charts. American Hospital Association, Jan. 2017. http://www.aha.org/research/rc/stat-studies/Pie-charts2017.shtml

Table 2.1: Number of community hospitals, 1991-2014. In: Trendwatch Chartbook 2016, American Hospital Association, May 12, 2016. http://www.aha.org/research/reports/tw/chartbook/2016/table2-1.pdf. Related chart 2.4: Number of hospitals in health systems, 2004-2014: http://www.aha.org/research/reports/tw/chartbook/2016/chart2-4.pdf

Posted by AHA Resource Center, (312) 422-2050, rc@aha.org