Tag Archives: PCP

DOCS GENERATE AN AVERAGE $2.4M A YEAR PER HOSPITAL

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , • Leave a comment

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.”

 

 

 

 

BCBS of Georgia to stop covering ED visits it deems unnecessary

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , • Leave a comment

http://www.beckershospitalreview.com/payer-issues/bcbs-of-georgia-to-stop-covering-ed-visits-it-deems-unnecessary.html

Image result for blue cross of georgia

Starting next month, Anthem Blue Cross Blue Shield of Georgia will no longer cover emergency department services it determines are unnecessary for members with individual plans.

The insurer said the policy aims to steer patients with nonemergent symptoms to see a primary care physician, urgent care provider or use its LiveHealth telehealth app to limit costly ED visits. If a BCBS of Georgia policyholder receives care for nonemergent symptoms, a medical director will use the prudent layperson standard to deem whether the service is necessary.

Jeff Fusile, president of BCBS of Georgia, told WABE, “The cost of care’s been going up so much faster than people’s earnings. We have got to find a better way to do some of this stuff, taking some of that unnecessary spending out of the system.”

The policy does not include referrals from a physician to the ED for nonemergent services, nonemergent services provided to children under age 14, instances when an urgent care clinic is more than 15 miles away and when care is administered on Sundays and major holidays.

“We’re not trying to steer people away from the emergency room if they have a serious condition,” Debbie Diamond, director of publications for BCBS of Georgia, told Becker’s Hospital Review. “If a member is having chest pain that they think is a heart attack, they should still go to the emergency department.”

Ms. Diamond said similar policies have been enacted at Anthem-affiliated plans in Missouri, Kentucky and Virginia. Missouri said it would reinforce the program June 1 and Kentucky enacted the policy in 2015.

Donald Palmisano, president of the Medical Association of Georgia, told WABE the policy disproportionately affects the elderly, rural residents and children over the age of 14. He added physicians are concerned the policy places “the patient, who doesn’t have the clinical background, to determine whether their condition is of an emergency nature.”