DOCS GENERATE AN AVERAGE $2.4M A YEAR PER HOSPITAL

https://www.healthleadersmedia.com/finance/docs-generate-average-24m-year-hospital

Family physicians provide an excellent ROI, earning an average $241,000 as a starting salary but generating nine times that amount in hospital revenues.


KEY TAKEAWAYS

Invasive cardiologists were No. 2 on the list of money makers for hospitals, generating an average of $3.5 million, followed by neurosurgeons at $3.4 million, and orthopedic surgeons at $3.3 million.

The average net revenue generated by all physicians in the survey, $2,378,727, is up 52% from 2016.

The increase in net revenues was attributed to more outpatient visits, higher costs per hospital stay, and sicker patients as the population ages.

Physicians each generate an average of nearly $2.4 million in revenues annually for their hospitals, a new survey finds.

Cardiovascular surgeons, on average, generated $3.7 million for their hospitals, topping the list of money makers among the 18 specialties examined in the survey of hospital chief financial officers, which was conducted by Dallas-based physician recruiters Merritt Hawkins.

The money includes net inpatient and outpatient revenue derived from patient hospital admissions, tests, treatments, prescriptions, and procedures performed or ordered by physicians.

“The value of physician care is not only related to the quality of patient outcomes,” said Travis Singleton, Merritt Hawkins’ executive vice president.

“Physicians continue to drive the financial health and viability of hospitals, even in a healthcare system that is evolving towards value-based payments,” Singleton said.

Invasive cardiologists were No. 2 on the list of money makers for hospitals, generating an average of $3.5 million, followed by neurosurgeons at $3.4 million, and orthopedic surgeons at $3.3 million.

Primary care physicians pulled their weight too, according to the survey.  Family physicians generate an average of $2.1 million in net revenue, while general internists generate an average of almost $2.7 million.

The average net revenue generated by all physicians in the survey, $2,378,727, is up 52% from 2016, the last year Merritt Hawkins conducted the survey.

Average revenue generated by each of the 18 medical specialties included in the survey increased compared to 2016, in most cases significantly.

Even though inpatient stays declined or flat-lined in recent years, Singleton attributed the increase in net revenues to more outpatient visits, which have more than tripled since 1975,   higher costs per hospital stay, and sicker patients as the population ages.

“Demographics are our destiny,” Singleton said. “New delivery models that promote prevention, population health and fee-for-value are laudable innovations but they don’t change the basic facts.  People get older and require more medical care, with much of it ordered by or directly provided by physicians.”

While primary care physicians are not the top revenue generators for their hospitals, Singleton says they represent an excellent return on investment.

Family physicians average $241,000 as a starting salary, according to Merritt Hawkins’ data, but they generate nine times that amount in hospital revenues. Orthopedic surgeons, with an average starting salary of $533,000, generate six times that amount for their hospitals.

“PHYSICIANS CONTINUE TO DRIVE THE FINANCIAL HEALTH AND VIABILITY OF HOSPITALS, EVEN IN A HEALTHCARE SYSTEM THAT IS EVOLVING TOWARDS VALUE-BASED PAYMENTS.”

 

 

 

 

A Brief Analysis of Health Insurance Competition and Commercial Market Share

http://www.markfarrah.com/healthcare-business-strategy/A-Brief-Analysis-of-Health-Insurance-Competition-and-Commercial-Market-Share.aspx

Pennsylvanias Commercial Market as of December 2016

Health plan market share is an important measure of competitive positioning for insurers. Health insurance carriers often assess the number of people enrolled in their health plans at the state level or at a more defined geographic area to determine their market position. Companies not only look at their own market position but also routinely analyze competitor membership to evaluate relative market share. In this brief, Mark Farrah Associates (MFA) presents an overview of market demographics and market share data, with a focus on health plan market position in three Metropolitan Statistical Areas in Pennsylvania.

Market Demographics

Health insurance competition can be assessed by using many performance variables with health plan enrollment and market share metrics being the most common. Enrollment can be divided into two core segments, commercial health insurance and government-sponsored programs. The largest segment within the commercial market is employer-based plans, also known as the group segment. The group segment includes fully-insured/risk-based policies or self-funded/ASO (administrative services only) arrangements with employers. Individual or non-group plans, including Marketplace products, are also part of the commercial segment. Government programs, Medicare and Medicaid, provide coverage for the elderly or people with disabilities and low income populations.

As of December 31, 2016, insurance companies provided medical coverage for approximately 264 million people, based on enrollment as reported in Mark Farrah Associates’ Health Coverage Portal™. The employer-based ASO and risk-based segments remained the largest sources of coverage in the industry, collectively enrolling 196 million people in the commercial segment. Medicaid and SCHIP programs enrolled nearly 75 million people and within this segment, approximately 51 million are covered by managed care plans. Approximately 57 million seniors were enrolled in Medicare programs at year-end 2016. This included more than 38.7 million people with original Medicare and 18.7 million members enrolled in Medicare Advantage plans.

Competition and Market Share

To analyze health insurance competition, analysts often start with state-by-state assessments of competitor enrollment and market share. Data from statutory filings can provide valuable insights about state health insurance competition. Based on data filed in statutory financial reports from the NAIC (National Association of Insurance Commissioners) and the CA DMHC (California Department of Managed Health Care), Mark Farrah Associates’ Health Coverage Portal™ is a tool widely used by health plans for easy access to market share data and financial performance metrics.

For the purposes of this brief, MFA first looked at the competitive mix in Pennsylvania’s commercial market by analyzing state enrollment figures from the Health Coverage Portal™. The chart below illustrates the leading companies in Pennsylvania’s commercial health insurance market. Three Blue Cross Blue Shield affiliates and Aetna comprise the largest percentage of market share for the state.