MDNews - Central New York

A S U R V E Y O F cardiology, OB/GYN, dermatology, orthopedic surgery and family medicine practices in 15 metropolitan areas across the United States suggests average Medicaid acceptance has dropped in those specialties since the 2010 enactment of the ACA. Dallas-based physician recruitment fi rm Merritt Hawkins found acceptance across the fi ve specialties was 53 percent in 2017, compared with 55.4 percent in 2009. The highest acceptance rates in 2017 were in: + Minneapolis — 97 percent + Boston — 84.6 percent + Philadelphia — 76.6 percent + Portland — 72.8 percent + Detroit — 57.2 percent The lowest rates were in: + New York and Atlanta — 39 percent + Houston and Miami — 37 percent + Dallas — 17 percent "In some cases, reimbursement rates provided by Medicaid to particular specialists may be below their cost of providing services," the survey notes. "If not actually below costs, Medicaid reimbursement often is relatively low compared to that offered by other payers." ■ — Steve Barrett W H I L E T H E SH I F T to greater physician e m p loy m e n t i n re ce n t ye a rs h a s b e e n undeniable, private practice is scarcely on life support and may even enjoy a bit o f a co m e b a c k , a cco rd i n g t o M a r k W. Lowe, CHBC, EA, a Senior Management C o n s u l t a n t a n d A s s o c i a t e D i re c t o r o f Consulting at Knoxville, Tennessee-based co n s u l t i n g f i r m D o c t o r s M a n a g e m e n t . Here are a few of the key reasons why, Lowe explains on the company's website: + GREATER INDEPENDENCE Good outcomes call for nimble, flexible thinking. Private practices often foster this in a way that appeals to physicians. + DIRECT CARE OPTIONS Care based on cash payments rather than filtered through the insurance bureaucracy can free up phy- s i c i a n s t o s p e n d m o re — a n d m o re s a t i s f y i n g — t i m e with patients. + A LEVEL OF DEFERENCE Some physicians find they earn more respect in private practice than they receive in a number of other healthcare settings. ■ — Steve Barrett Medicaid Acceptance May Be Declining Physician Survey: Penalties Would Not Deter Care reimbursement often is relatively low compared to that offered by — Steve Barrett Here are a few of the key reasons why, Lowe can free up phy- New Life for Private Practice? THE OVERWHELMING MA JORIT Y of the nearly 8,000 physicians who responded to a 2016 Medscape survey said they would not withhold treatment to avoid a fi nancial penalty levied for going over their organization's care budget. Approximately 78 percent of the physicians, who represent more than two dozen specialties, said they would deliver care despite that risk. The fi gure was 74 percent in 2014. They were not sanguine, however, about what might happen as a result. One family physician who indicated an unwillingness to withhold care for fi nancial reasons lamented, "And that is why I would be fi red." Respondents who did not reject outright the possibility of with- holding care are not necessarily saying they would deny needed treatment, Arthur Caplan, PhD, a bioethicist at NYU Langone Medical Center, told Medscape. "Hopefully if they answered 'Yes' or 'It depends,' they are thinking of other positive treatment strategies that they could pursue, rather than simply withholding treatment," Caplan said. ■ — Steve Barrett 2 2❱❱❱❱❱ B U S I N E S S O F M E D I C I N E

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