Left unchecked, most trends in how physicians organize and practice medicine are likely to lead to higher spending and declining access to care for lower-income people, according to an article by Center for Studying Health System Change (HSC) researchers in the November/December Health Affairs.
“Physicians are moving into larger practices and loosening affiliations with general hospitals; providing more ancillary services; and investing in enterprises that compete with hospitals for outpatient, or even inpatient, services,” write Hoangmai H. Pham, MD, a senior HSC researcher, and Paul Ginsburg, PhD, president of HSC.
The authors also point to the steady decline in the proportion of physicians willing to care for uninsured and Medicaid patients, writing that, “More disturbingly, current trends in the delivery of physician services may contribute to an increasingly tiered delivery system. Physician-owned facilities are less likely than general hospitals to serve Medicaid beneficiaries or the uninsured. The increasing prevalence of physicians opting to drop contracts with insurers to receive higher out-of-network payments from patients will contribute further to disparities in access to providers.” Read the abstract.
