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Stethoscope on $100 bills.
Here's another shift in health care to go along with shrinking rate of growth in health care spending over the last few years: For the first time, primary care doctors are driving more revenue on a per/physician basis for hospitals than specialists. That's the finding in a new survey of hospital financial officers by physician recruiting firm Merritt Hawkins.
For 2013, the median revenue per primary care physician ascribed by about 3,000 hospital chief financial officers is nearly $1.6 million, and it is a little more than $1.4 million for specialists. In 2010, the last time Merritt Hawkins did such a survey, primary care was at more than $1.4 million, and specialties were at nearly $1.6 million. Specialists have outpaced primary care in Merritt Hawkins' survey, which began in 2002, continued in 2004 and has been conducted every three years since. The survey includes both inpatient and outpatient revenue generated for hospitals, and it does not give an aggregate total of the revenue generated by primary care and specialty physicians. [...]

“A seismic shift is taking place in medicine, away from specialists and toward primary care physicians,” said Mark Smith, president of Merritt Hawkins, in a statement. “Primary care physicians are increasingly employed by hospitals and in new delivery models, such as accountable care organizations. They are taking a greater role in driving both the delivery of care and the flow of health care dollars.”

Note that this is among physicians who are employed by hospitals, not independent providers. Researchers attribute much of the shift to the emphasis the Affordable Care Act puts on primary care, and the increasing role of primary care physicians in health care delivery because preventive services are now provided for patients with insurance without co-pays. Demand for these services is increasing, just as demand for primary care physicians will be increasing. Medicare provider cuts are also a factor. Not mentioned in the story, but another potential factor in the decline in specialist revenue is the recession and how people have curtailed spending because of it.

Given that the Affordable Care Act is going to create demand for primary care providers that will be a challenge to meet, it's good that these doctors are also increasing revenue for hospitals—that should drive more hiring and potentially better pay for these providers. Better pay could drive more medical school students into primary care instead of specialities.

Originally posted to Joan McCarter on Mon May 20, 2013 at 02:46 PM PDT.

Also republished by Daily Kos.

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