Is Obamacare Responsible For Demise Of Private Practices?
By John Oncea, Editor
Follow John on Twitter: @buck25
Critics of the Affordable Care Act say it is killing off private practices and will add tens of millions to newly created health insurance exchanges – far more than the eight million the Obama administration estimated.
Health IT Outcomes recently looked at the future of private physician practices and found they are still viable, but their future was very much in doubt. Reader Chris Diaz commented, “This is the result of Obamacare.” Following is Diaz’ entire response:
The Motley Fool recently weighed in on the topic, writing, “The trends show the numbers of physicians practicing privately are steadily dropping. Some blame Obamacare for pushing doctors out the door. Is this accusation based on fact or fantasy?”
Citing two surveys, one conducted in 2012 by the Doctor Patient Medical Association and the other conducted in 2013 by Deloitte, Motley Fool concludes, “The reality is that, regardless of physicians' opinions about Obamacare, the law is contributing to more doctors moving away from private practices. Health care reform emphasized close collaboration between health care providers through Accountable Care Organizations, or ACOs, and bundled payments. Many expected private physician practices to be acquired with this focus -- and they were right.”
Two years ago, The New England Journal of Medicine (NEJM) reported on the shifting of physicians from private practices to hospitals as a reaction to “the implementation of health care reform” writing, “More than half of practicing U.S. physicians are now employed by hospitals or integrated delivery systems, a trend fueled by the intended creation of accountable care organizations (ACOs) and the prospect of more risk-based payment approaches.” The NEJM article concludes with the sobering news that even though “hospital employment may offer physicians some protection from system reforms,” it comes with “more performance management than it once did, and the option of reverting to independent practice later may be far less attractive in the future. Employment choices that physicians make today may not be able to be undone.”
The demise of the private practice is just one scenario critics point to when discussing the Obama administration’s healthcare plan. A second scenario – the possibility that Obamacare subsidies will drive employers to drop coverage – is addressed by Life Science Leader magazine. The article asks, “How will employers react when they realize that they can typically save $18,000 for a family policy and only pay a $2,000 penalty so their employees can get subsidized coverage in the exchange?” The author answers his own question, writing an employer “could drop coverage for its employees, direct them to obtain coverage in the exchange, pay the $2,000 penalty, and both the employees and the employer would be better off.”