Physician Organization Leadership Frustrated With Shrinking and Changing Payer Reimbursement, Increasing Administrative Work Load

“Reimbursement that does not even cover costs”

Shortages of primary care physicians: fewer primary care physicians in the face of more patients means those in practice will have to shoulder more responsibilities, is a key challenge cited by a vice president of a physician practice management company.

Along with that issue physicians “juggling increased administrative burdens with maintaining patient quality of care,” the VP observed.

The concerns of executives and administrators of physician organizations emerge from the results of the IPA -PHO Physician Organization Leadership Survey 2012 by the Managed Care Information Center (MCIC.)

The National Directory of Physician Organizations Database is produced by the MCIC.

https://www.healthresourcesonline.com/managed_care/23poe.htm

Declining compensation and lower reimbursement has been and continues to be a major concern survey respondents told us.

“Reimbursement that does not even cover costs,” is how the regional VP of payer relations for an IPA put it.

“Many MCOS are decreasing reimbursement for several therapeutic classes,” A PHO director of pharmacy said.

The director of operations for an IPA cited another problem “changing reimbursement models and having the cash flow to fund changing practice models,” the same issue cited by the executive director of a manager services organization.

Also reimbursement related is the challenge of “transformation of primary care practices to a pay for quality reimbursement strategy,” offered an executive director of a PHO.

Then there is the temptation of throwing in the towel: “If the value of the organization does not continue to prove itself to grow revenue and cut costs, practices may consider becoming hospital employees,” according to an IPA executive director.

Other issues physician organization leaders struggle with, the survey found, include:

  • Physician juggling increased administrative burdens with maintaining patient quality of care,
  • Lack of education and emphasis on cost/utilization in the specialist community,
  • Meeting physician quality reporting standards,
  • And, assisting physicians in developing mechanisms to ensure patient compliance.

The exclusive Physician Organization Leadership Survey was conducted online among physician organization executives and members of the Managed Care Information Center’s online community.

The National Directory of Physician Organizations Database is produced by the Managed Care Information Center.

https://www.healthresourcesonline.com/managed_care/23poe.htm

Copyright 2012 Managed Care Information Center, Health Resources Publishing LLC.

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