Chris--
The medical profession is dying, and corporate "healthcare" is the apparent winner.
Its the independent medical practices that are dying and here are a few of the reasons
1. I think there higher payments for the same billing code for hospital owned practices compared to independent practices
2. Insurance companies can drop physicians at their discretion from their plan and it is mostly the independent practices.
3. Accountable care organizations mandate patients to change their pcp if you do not join them and thereby causing a lot of distress to our long term patients and also financially impact independent practices.
4. The meaningless rules and regulations imposed on medical practices primarily affect the independent practices.
5. Independent practices do not have the clout or the finances to fight the insurance companies or the bureaucracy.
6. Lastly independent practices have no one to fight for our cause to remain independent
Inspite of all the burdens and obstacles placed on independent practices.. I am happy to independent as long as I can.
Grenville
*I'm pretty sure that in my area, the payment is actually less for a hospital practice. Therefore the hospital has established new LLC's to run their outpatient clinics.
*I have not seen any insurance companies dropping individuals. More of a problems is independent doctors or hospitals deciding to join PPO, then forcing everyone to accept the same low payments. Behind this is greed; wanting to take market from others even though it pays less. Greed and stupidity. Same thing with jointing ACO's. I am fiercely against being manipulated this way, why isn't everyone?
*Independent doctors can form loose professional associations that allow them to bargain collectively, declined PPO's in group, and so on.
All is not lost. We need to fight for our independence. I blame too many doctors for throwing up their hands and joining employment with hospitals. Why would you do that just because of meaningful use (now dead). I don't know why thousands of doctors said the computers and business were to complicated and did this. I'm still in solo, private practice. I make more than hospital doctors. I control my hours, my staff, my billing company, and which patients and insurance I take. Having control over your life = satisfaction.
Remain independent, look for niches like Direct Pay, Concierge, Cash Pay with discounts, industrial medicine, etc. Consider drastic measures, such as dumping your worst payer, even if that is Medicaid, Medicare, and so on.