Consolidation has been very visible at the hospital level of the health care industry, but physician practices have been looking to join larger groups or find hospital employment since before the Affordable Care Act was introduced, according to John Fanburg, head of the health care practice at Brach Eichler, the firm that produced the survey.
Fanburg said he recently spoke to a hospital CEO who entertains three or four phone calls a day from physicians looking to be bought out.
“With reimbursement pressures, physicians have really begun to do things. Part of it is, the (one- to three-) person practices, it’s really hard to cover the overhead in light of declining reimbursement, so they need to be part of a larger group,” Fanburg said. “There’s pressure for electronic medical records and more sophisticated billing systems, those in themselves are very expensive. You need other providers who can help pay for that.”
Fanburg added that cardiologists, in particular, have been hurt by declining reimbursements, and hospitals have been very active in hiring primary-care doctors and cardiologists to maintain a larger patient population.
Other results from the survey show New Jersey’s doctors generally are seeing stable income, with nearly 48 percent reporting the same earnings over the previous year. Also, one third of the state’s physicians have either already joined or are considering joining an accountable-care organization, where financial risk is spread across a continuum of health care providers.
Fewer than 10 percent of the surveyed physicians see a favorable impact coming from implementing the Affordable Care Act, and about one-third of practitioners are taking a wait-and-see approach in complying with the law.
Fanburg said the most concerning result of the survey was that, in 2012, almost 15 percent of physicians indicated they will retire, while 11 percent said they are leaving New Jersey to practice elsewhere.
“We’re very fortunate, in terms of access to health care in New Jersey … but access to care is going to become another problem for us that we’re not used to dealing with,” Fanburg said. “You don’t have people to replace them.”