Although physicians remain the primary owner for the majority of cardiovascular practices, the number of physician-owned practices continues to decline, while hospital ownership is on the rise, according to a survey completed by the American College of Cardiology.
A total of 2,520 practices from all 50 U.S. states and Puerto Rico participated in this study.
The survey found physicians owned 73 percent of practices and hospitals owned 8 percent in 2007. Currently, 60 percent of practices are physician-owned, while 24 percent are hospital-owned. The number of cardiovascular professionals working for hospitals also has increased.
Of the 556 practices that have merged/integrated, two-thirds said day-to-day operations changed post integration, but two in five practices still have some management in operations. The changed practice setting has generally either stayed the same or improved; it has worsened for two in ten practices.
According to the data, an equal percentage of practitioners (35 percent) are now currently employed by hospitals as are physician-owned, compared with 2007 when 59 percent of practitioners were in private practice and only 11 percent were employed by hospitals.
The survey revealed a flurry of activity for U.S. cardiology practices:
- 546 practices (representing approximately 6,680 cardiologists) have a new ownership structure (no longer physician owned/private);
- 133 (959 cardiologists) are in discussions about hospital integration;
- 148 practices (967 MDs) are considering hospital integration;
- 72 practices (1,533 cardiologists) have merged with another practice;
- 48 (286 cardiologists) are in discussions about practice merger;
- 22 practices (237 MDs) are engaged in dissolution activity; and
- 25 practices (41 MDs) have closed their practice.
The Practice Census also showed that continued cuts to Medicare physician payments, as well as reimbursement in general, are by far the top two issues keeping more than 70 percent of private practitioners awake at night. Coding, billing and expense management also were major challenges highlighted by private practice providers. Hospital-owned practices, which listed Medicare payment and reimbursement as top issues, also cited workflow management (38 percent), hospital/practice alignment (40 percent) and health IT implementation (36 percent) as their top challenges.
“Congress must eliminate the red tape so that physicians can focus on patients and not paperwork,” ACC President William A. Zoghbi, MD, said in a statement. “We are asking members of Congress to finally repeal the flawed SGR [sustainable growth rate] formula, oppose unnecessary cuts to medical imaging services, and work with the health care community to test and implement new payment models outside of the current fee-for-service system.”