Survey: Outlook bleak for independent practices, small groups
Sixty-two percent of physicians surveyed are pessimistic about U.S. physicians' ability to practice independently or in small groups in the future, according to a study conducted by health IT company athenahealth and the Physician Sentiment Index (PSI) from Sermo, an online physician community.
One thousand physicians responded to questions revealing pain points and frustrations relating to the business of medicine, reimbursement protocols, the government's hand in healthcare and other variables concerning the delivery of quality care in the U.S., according to athenahealth, of Watertown, Mass., and Sermo's PSI.
Many physicians' responses convey a feeling that they have lost control over their own profession, according to the survey: 64 percent cited the current healthcare climate as somewhat or very detrimental to their delivery of quality care, and 59 percent of respondents believe the quality of medicine in the U.S. will decline in next five years.
Only 16 percent of respondents said they are basing their clinical decisions on what they think is best for the patient, rather than what payors are willing to cover, according to the survey.
Fifty-four percent of respondents strongly disagreed or disagreed that more active government involvement in healthcare regulation can improve outcomes; less than a quarter felt otherwise, the survey showed. A shift from fee-for-service to pay-for-performance gives hope to almost half (49 percent) who think it will have a very or somewhat positive impact on quality of care, the company added.
However, 53 percent believe pay-for-performance will have a negative or very negative impact on the effort required to get paid.
According to the PSI, frustration with payors' changing reimbursement protocols and regulations is nearly universal among physicians. Seventy-seven percent strongly agree or agree that time spent with payors and third parties inhibits their ability to spend time with patients and 92 percent strongly agreed or agreed that getting paid by insurers has become increasingly burdensome and complex. Similarly, 81 percent strongly agreed or agreed that getting paid by Medicare has become more burdensome and complex, compared with 83 percent who felt the same about Medicaid.
Almost a quarter of doctors responding to the survey are primary decision makers with respect to billing and administrative decisions, yet few exhibited a clear understanding of the business end of their practices (only 25 percent could correctly define the term 'cash flow'). In addition, 33 percent didn't know their average length of time for accounts receivable (for 51 percent, the average length of time is somewhere between 30 and 90 days) while 43 percent didn't know their insurance submission rejection rate.
Among physicians who knew their submission rejection rate, a range of 5-10 percent was most commonly cited, the survey showed. And for the practices of responding physicians who claimed to know their income, the average income is $2.5 million--which could mean $125,000 to $250,000 in deferred or lost income per practice.
Doctors' opinion on EHRs were highly favorable (81 percent expressed a very favorable or somewhat favorable opinion), the survey found, but only 51 percent of respondents felt EHRs are designed with them in mind and 54 percent strongly agreed or agreed that EHRs slow down the doctor during patient exams.
To view the full discussion on issues related to the PSI, click here.
One thousand physicians responded to questions revealing pain points and frustrations relating to the business of medicine, reimbursement protocols, the government's hand in healthcare and other variables concerning the delivery of quality care in the U.S., according to athenahealth, of Watertown, Mass., and Sermo's PSI.
Many physicians' responses convey a feeling that they have lost control over their own profession, according to the survey: 64 percent cited the current healthcare climate as somewhat or very detrimental to their delivery of quality care, and 59 percent of respondents believe the quality of medicine in the U.S. will decline in next five years.
Only 16 percent of respondents said they are basing their clinical decisions on what they think is best for the patient, rather than what payors are willing to cover, according to the survey.
Fifty-four percent of respondents strongly disagreed or disagreed that more active government involvement in healthcare regulation can improve outcomes; less than a quarter felt otherwise, the survey showed. A shift from fee-for-service to pay-for-performance gives hope to almost half (49 percent) who think it will have a very or somewhat positive impact on quality of care, the company added.
However, 53 percent believe pay-for-performance will have a negative or very negative impact on the effort required to get paid.
According to the PSI, frustration with payors' changing reimbursement protocols and regulations is nearly universal among physicians. Seventy-seven percent strongly agree or agree that time spent with payors and third parties inhibits their ability to spend time with patients and 92 percent strongly agreed or agreed that getting paid by insurers has become increasingly burdensome and complex. Similarly, 81 percent strongly agreed or agreed that getting paid by Medicare has become more burdensome and complex, compared with 83 percent who felt the same about Medicaid.
Almost a quarter of doctors responding to the survey are primary decision makers with respect to billing and administrative decisions, yet few exhibited a clear understanding of the business end of their practices (only 25 percent could correctly define the term 'cash flow'). In addition, 33 percent didn't know their average length of time for accounts receivable (for 51 percent, the average length of time is somewhere between 30 and 90 days) while 43 percent didn't know their insurance submission rejection rate.
Among physicians who knew their submission rejection rate, a range of 5-10 percent was most commonly cited, the survey showed. And for the practices of responding physicians who claimed to know their income, the average income is $2.5 million--which could mean $125,000 to $250,000 in deferred or lost income per practice.
Doctors' opinion on EHRs were highly favorable (81 percent expressed a very favorable or somewhat favorable opinion), the survey found, but only 51 percent of respondents felt EHRs are designed with them in mind and 54 percent strongly agreed or agreed that EHRs slow down the doctor during patient exams.
To view the full discussion on issues related to the PSI, click here.