As enrollment in Obamacare begins, physicians throughout the country are preparing to deal with an influx of newly insured patients – as well as the increased financial demands this will place on their practices.
However, 2 key factors stand in the way.
1. Physician shortage
The American Association of Medical Colleges (AAMC) estimates that the U.S. will face a physician shortage of over 90,000 physicians by 2020 – a figure that’s expected to reach over 130,000 by 2025. This shortage is propelling physician extenders into an increasingly important role in primary care as more healthcare providers employ them to fill the gap.
Until now, third-party reimbursement has allowed physician practices to profit by using doctors as primary caregivers. Because of the current fee-for-service and fee-for-procedure payer agreement, each patient is charged for the office visit, each procedure done and the supplies used. And insurance pays for some (or all) of these charges.
Now, providers will start being paid a lump sum to manage a patient population. And this lump sum is much less than what they’ve been paid in the past to see and treat the same patients.
So how do you remain profitable?
Before I answer that let’s be clear. There’s no way to replace the care a physician provides when it is needed.
Profitable physician practices will have a few options to succeed with this new model, including:
- Seeing more patients in the same amount of time and while maintaining quality
- Employing physician extenders who can help see more patients at a lower cost than MDs while maintaining quality care
To me, physician extenders sound like the better option.
In case you aren’t familiar with this term, “physician extenders” include physician assistants (PAs) and nurse practitioners (NPs) that function under the supervision of a physician, and may diagnose, order tests, develop treatment plans and write prescriptions.
What are the benefits of physician extenders?
Physician extenders can often offer financial profitability for the practice as well as efficiency, improved quality of care, enhanced flexibility for physicians and greater patient satisfaction.
Reduced salary expenses
The base physician salary can be more than double that of physician extenders. If you can hire a PA, you’ll get similar expertise for a fraction of the cost. This is one of the biggest benefits for physician practices.
Just think… you can get another person to help you practice and do almost the same things, and not have to pay what you would for a physician.
Higher patient volumes
Physician extenders help alleviate some of the routine work for physicians, to help maximize office hours and treat more patients. A study published in Health Affairs found that patients are still likely to see a doctor, but if they know they have to wait for the doctor, they’re happy to see a PA or NP instead. And with the influx of patients, everyone’s expertise and help is needed.
Maintaining quality of care
By hiring a physician extender, you can expand your medical staff, ensuring patients receive medical care faster, get all their questions answered and are better satisfied with their healthcare team as a whole.
Physician extenders can help maintain care quality because of the extra time they can spend with patients.
What can be better than having an extra pair of medically trained eyes and hands assisting you? Imagine having extra hours in the week to research, concentrate on difficult cases or take much-needed time away from the office. Physician extenders can lighten your workload considerably, giving you more time to do what you need to do.
Greater patient satisfaction
As we continue to shift toward a patient-centric model of care, satisfaction ratings are becoming increasingly important. Popular consumer-facing websites like Healthgrades and Vitals let patients rate their experience, which can affect a practice’s retention rate and ability to add new patients.
Studies have consistently shown that PAs provide high-quality care with outcomes similar to physician-provided care. Studies have also shown that patients are just as satisfied with medical care provided by PAs as with that provided by doctors and do not distinguish between types of care providers.
Putting it all together
State and regional practice guidelines will soon be established to put best practice standards in place. Currently, physician practices are averaging around 1:2 MDs to PAs. Going forward, these same practices will need to look at moving to around 1:6 or even 1:8 MDs to PAs to remain profitable.
While these guidelines are still being established, it’s become more important to have the proper tools in place to run a profitable physician practice.
With proper business intelligence tools, you’ll gain competitive peer information that can be used to establish practice-level targets, organizational charts and skill mix assessment. And use internal productivity tools to ensure operations are being managed to the budget.
So have I convinced you that physician extenders are one of the keys to profitability under healthcare reform? Let me know your thoughts below.