Joseph Rugg's Health Law Blog

Physician practices are dealing with increased demands from the government, from managed care companies, from employers, and from patients to provide higher quality and better access to health care at cheaper costs.  While these demands existed before health law reform, health law reform has exacerbated the pressures and the uncertainties on physicians and their advisors.  Most of the alternatives for responding to these demands have been around for some time, but the need for more decisive action has greatly intensified.  Some of the intensity is artificial, fueled by the fear of being left behind.  In some cases, it is too early to do anything, because so much is still in flux.   Newspapers, magazines, professional websites, and blogs are reporting on these issues more and more.  This is likely to add to the confusion of what to do and when to do it.

Nevertheless, neither opportunities nor threats can be ignored.  Physicians and their advisors must be alert and be prepared to act when the time is appropriate.  Premature action may be as hurtful as delay.  Staying informed is critical.

Here is a list of practice alternatives that I am seeing, and my physician clients are experiencing (and, in some cases, adopting).  The list is not meant to be exhaustive, and I would like to hear what any of you or your clients are experiencing in this time of professional, economic, and legal uncertainty.

• Internal improvement of practice management — e.g., better billing and collection procedures, adoption of EHRs, employing more skilled administrative support staff
• Expansion of healthcare services being offered — e.g., adding nontraditional healthcare services, employing specialists
• Engaging outside practice management companies
• Consolidation/merger of solo and small practices with larger, same specialty practice groups
• Consolidation/merger/affiliation with multi-specialty practice groups
• Affiliation with IPAs, PHOs, and now ACOs
• Sale of practice to national practice management, single specialty, and multi-specialty corporations
• Sale to, affiliation with, or employment by hospital organizations
• Opting out of Medicare and managed care plans and establishing a concierge practice for selected patients

Over the next several postings, I will review these alternatives and discuss the issues involved.