PwC: Hospitals and docs need to get over trust issues
Health reform will require hospitals and physicians to engage in more intense levels of collaboration and information sharing; however, both groups must overcome trust and IT issues, according to a survey from PricewaterhouseCoopers' (PwC’s) Health Research Institute (HRI).
During the summer, PwC's HRI commissioned an online survey of more than 1,000 physicians across the country, balanced by age, gender, practice type and specialty, and conducted 15 in-depth interviews with thought leaders and executives representing healthcare providers, payors and professional associations.
“One in five physicians doesn’t trust hospitals, and six in 10 hospitals think it will be difficult to get health information from community physicians to provide more effective, efficient care,” the report found.
According to the study’s authors, the relationship between hospitals and physicians was strained after hospitals bought and then sold hundreds of physician practices in the 1990s--after which many physicians opened competing outpatient surgery and imaging centers and specialty hospitals.
PwC found that health reform is reversing the trend. Seventy-one percent of physicians surveyed already have aligned financially with hospitals through employment, joint ventures or directorships, and 58 percent said they want to move toward an even closer financial relationship with hospitals. Nearly one-quarter said they already work primarily in hospital practice settings.
Among specialties, cardiology is the most interested in being employed by hospitals and orthopedics is least interested. Sixty-three percent of cardiology specialists--compared to 48 percent of primary care physicians and 45 percent of all other specialists--said they are interested in being employed by hospitals.
“The cardiology specialty has been among the most lucrative of all physician specialties, but it has experienced the deepest cuts in Medicare payments. Physicians interviewed by PwC expressed fear that this is a precursor for further future cuts in other specialties,” the report stated.
When asked why they want to align with hospitals, physicians cited relief from growing financial and administrative burdens and fear of income loss in anticipation of reimbursement cuts. Sixty-three percent of physicians are looking to align with hospitals for better work-life balance, 56 percent want to increase their incomes and another 40 percent are looking for a more consistent income stream.
When asked why they think hospitals are motivated to align with them, 68 percent of physicians said they believed hospitals are looking to consolidate market power to negotiate reimbursement rates with payors. Sixty-four percent believed hospitals want improved patient outcomes and 56 percent think hospitals want to align with physicians to enhance coordination of patient care.
More than half (54 percent) of physicians believed that hospitals and physicians will become more closely aligned over the next five years as more hospitals participate in accountable care organizations.
“Old incentives that rewarded hospitals and physicians for the volume of sick patients treated are being replaced with new incentives to improve health outcomes and keep people well," the report concluded. "Better quality will finally pay off, but hospitals and physicians need to work together. Hospitals are looking to provide physicians with appropriate incentives and develop their trust by sharing information, working together on infrastructure and collaborating in governance so that both sides have skin in the game.”
During the summer, PwC's HRI commissioned an online survey of more than 1,000 physicians across the country, balanced by age, gender, practice type and specialty, and conducted 15 in-depth interviews with thought leaders and executives representing healthcare providers, payors and professional associations.
“One in five physicians doesn’t trust hospitals, and six in 10 hospitals think it will be difficult to get health information from community physicians to provide more effective, efficient care,” the report found.
According to the study’s authors, the relationship between hospitals and physicians was strained after hospitals bought and then sold hundreds of physician practices in the 1990s--after which many physicians opened competing outpatient surgery and imaging centers and specialty hospitals.
PwC found that health reform is reversing the trend. Seventy-one percent of physicians surveyed already have aligned financially with hospitals through employment, joint ventures or directorships, and 58 percent said they want to move toward an even closer financial relationship with hospitals. Nearly one-quarter said they already work primarily in hospital practice settings.
Among specialties, cardiology is the most interested in being employed by hospitals and orthopedics is least interested. Sixty-three percent of cardiology specialists--compared to 48 percent of primary care physicians and 45 percent of all other specialists--said they are interested in being employed by hospitals.
“The cardiology specialty has been among the most lucrative of all physician specialties, but it has experienced the deepest cuts in Medicare payments. Physicians interviewed by PwC expressed fear that this is a precursor for further future cuts in other specialties,” the report stated.
When asked why they want to align with hospitals, physicians cited relief from growing financial and administrative burdens and fear of income loss in anticipation of reimbursement cuts. Sixty-three percent of physicians are looking to align with hospitals for better work-life balance, 56 percent want to increase their incomes and another 40 percent are looking for a more consistent income stream.
When asked why they think hospitals are motivated to align with them, 68 percent of physicians said they believed hospitals are looking to consolidate market power to negotiate reimbursement rates with payors. Sixty-four percent believed hospitals want improved patient outcomes and 56 percent think hospitals want to align with physicians to enhance coordination of patient care.
More than half (54 percent) of physicians believed that hospitals and physicians will become more closely aligned over the next five years as more hospitals participate in accountable care organizations.
“Old incentives that rewarded hospitals and physicians for the volume of sick patients treated are being replaced with new incentives to improve health outcomes and keep people well," the report concluded. "Better quality will finally pay off, but hospitals and physicians need to work together. Hospitals are looking to provide physicians with appropriate incentives and develop their trust by sharing information, working together on infrastructure and collaborating in governance so that both sides have skin in the game.”