The next year will both align and separate healthcare facilities and medical practices. All stakeholders in the healthcare industry are in agreement that reimbursements for services rendered must be maintained at the present levels or financial chaos could occur. Both sides agree that the system is broken and that during the transition to healthcare reform and change in reimbursement methodology significant issues are being forced upon them that are both complicated and costly. It is at this point that a separation of interests and difference of opinion occurs. This is where it becomes David vs. Goliath. We will have individual physicians and smaller medical groups trying to survive against large facilities (hospital delivery systems).

 

Hospitals are by far the largest healthcare facilities. To enhance market share and drive revenue, many hospitals are acquiring physician practices across a spectrum of specialties. Whether it is to increase revenue and secure admissions and outpatient services or be in a position to form an ACO is still to be determined. What is clear is that there will be two types of medical practices going forward: those that are hospital owned and those that are independent. Will hospitals directly support the physician practices they own by referrals to others within the hospital group to the detriment of the independent physician? This is a major paradigm shift with the hospitals controlling both sides of the equation. The hospital owned physician works under the umbrella of the hospital and is only responsible for providing care to the patient. The independent physicians will have to fend for themselves. Perhaps this will force the consolidation of single specialty and or multi-specialty medical groups and/or a re-alignment of referral patterns?

 

Since the early days of managed care the expression, “there will be winners and losers” has been around. The question is which side of the equation will you be on in 2012?