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    Top 10 challenges facing physicians in 2018


    9. Remaining independent in a time of value-based care initiatives 

    The ranks of independent primary care practices continue to dwindle. A report from the American Medical Association shows that the percentage of physicians with an ownership stake in their practice declined from 53% in 2012 to 47% in 2016. The rising cost of compliance with government reporting and changing reimbursement models has forced many doctors to either join larger physician groups or sell their practice to a hospital.

    Here are three strategies experts recommend to help physicians remain independent.

    1. Change the practice model

    If insurance reimbursements are declining and compliance costs are up, do away with both problems by contracting directly with patients via a direct primary care (DPC) model. Patients pay a flat monthly fee to the doctor in exchange for expedited access. By eliminating much of the documentation, billing and coding, doctors are able to spend more time with patients.

    2. Join an ACO or become a PCMH

    ACOs and patient-centered medical homes (PCMHs) are models that take a team approach to coordinating care across providers. The benefit to the physician is that patients receive better care, while many of the costs of compliance are shared across the group. Both ACOs and PCMHs may be eligible for additional payment bonuses from government and private payers, depending on their structure. 


    BLOG: This is why we need to accelerate value-based care


    For Lerla Joseph, MD, a primary care physician in Richmond, Virginia, participating in an accountable care organization (ACO) was a way to stay independent and handle increasing government regulations. “As a small practice, we’ve been challenged by many things in terms of electronic health records (EHRs), regulations and managing quality metrics,” Joseph told Medical Economics earlier this year. Although doctors in her area were increasingly deciding to become employees of hospitals or large groups, she had no interest in leaving private practice, because she felt she could better serve her community by remaining independent.

    3. Add ancillary services

    If reimbursement from standard medical care isn’t providing enough revenue to survive, consider adding ancillary services to boost the bottom line.

    In-house labs, echocardiography, X-rays, mammography, aesthetics and dietary assistance are all potential moneymakers, but experts warn to study the numbers carefully before making a commitment. Insurance reimbursement may not cover the full cost to provide a service, and patient demand may not be as high as projected.

    But if the patient population is right and the service is carefully studied before buying anything, ancillary services can add much-needed revenue that allows a practice to remain independent. 

    To learn more best practices from private practices, visit bit.ly/18-independence

    Next: Ever-changing healthcare insurance marketplace

    Rose Schneider Krivich
    Rose is the content specialist for Medical Economics.
    Todd Shryock
    Todd Shryock, contributing author


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