IT’S WIDELY KNOWN BY PATHOLOGISTS and laboratory administrators that hospitals and health systems are buying up private medical practices at an accelerating rate. This is a trend that favors hospital laboratory outreach programs, but may not be auspicious for the national laboratories.
For this reason, certain findings in the Medical Group Management Association’s (MGMA) latest survey of office-based physicians are revealing. The MGMA survey is given great credibility because it has been conducted for more than 50 years. It also includes data from 45,000 providers, making it “the largest provider population of any cost survey report in the United States.”
The report, titled “Productivity, Costs, and Revenue Linked to Practice Ownership” shows an interesting difference in productivity between physicians in private practice groups and physicians in medical groups owned by hospitals or integrated delivery systems (IDS).
First, the MGMA study authors looked at trends in relative value units (RVUs). For medical groups not owned by hospitals/IDS, over the past five years there was a .09% increase in total RVUs per patient and a 13% increase in work RVUs per patient.
By contrast, the survey determined that hospital/IDS-owned multispeciality groups reported a decrease of .55% in total RVUs per patient and a decrease of 17.85% in work RVUs per patient during the same five-year period.
The next finding is of more direct interest to clinical laboratories and pathology groups. The survey determined that, for non-hospital/IDS-owned medical groups, “the number of patients per provider has decreased nearly 9% in the past five years.” It was the opposite for hospital/IDS-owned medical groups, where the number of patients seen per provider increased by 9% over the same five years.
Capturing More Patients
This would imply that medical groups owned and operated by hospitals and health systems are capturing a larger share of patients compared to privately-owned medical groups. It is unclear what is causing physicians in hospital/IDS-owned medical groups to see almost 10% more patients per physician.
Still, it is important to recognize that, over a five-year period, the trend in the number of patients seen per physician is moving in opposite directions for privately-owned medical groups and hospital/IDN-owned medical groups. At a minimum, this must be considered a positive trend for hospital laboratory outreach programs. That’s because, whenever a hospital or health system buys a medical practice, that medical group is asked to switch its laboratory test referrals to the hospital/health system laboratory.
Further, the MGMA study also suggests that competition for patients is intense among medical groups in a community. Because hospitals and health systems are ongoing buyers of physician groups, it would appear that these community institutions will continue to buy up market share. Development of accountable care organizations (ACOs) will also fuel this trend.