IBJNews

Study: Quality, costs better at big practices

Back to TopCommentsE-mailPrintBookmark and Share

It looks like bigger is better when it comes to physician practices. A new study finds that large, multispecialty practices provides higher-quality care at slightly lower cost than their smaller compatriots.

The study found that quality was 5 percent to 15 percent higher at large, multispecialty practices than at small group practices.  Average costs were 3.6 percent lower, or $272 annually per patient.

The findings were published in the May issue of the journal Health Affairs. The study was conducted by Dartmouth University researchers using claims data from the federal Medicare insurance program for patients in 22 markets.

In the Indianapolis area, some of the largest physician practices are getting bigger. On Jan. 1, Indianapolis Neurosurgery Group merged with the IU Department of Neurology to form Goodman Campbell Brain and Spine, which includes 35 physicians.

The Indiana Clinic is trying to combine physician practices of Methodist Hospital and the Indiana University School of Medicine—and a few outsiders—into a 1,500-doctor practice by 2011. So far, 415 are on board.

The St. Vincent Physician Network added more than 30 doctors from the summer of 2008 to the summer of 2009. Now St. Vincent has agreed to acquire The Care Group—a practice of 130 cardiology and primary care doctors—in a deal that would double the amount of physicians employed by St. Vincent.

Physician accountants say many other practices have been growing by adding physicians one or two at a time.

The main factors forcing such mergers is declining reimbursement rates from the federal Medicare program for some specialist physicians (although primary care docs are getting an increase) as well as the high cost doctors face to add electronic medical systems before Medicare penalties begin in 2015.

The Dartmouth researchers suggested large, multispecialty physician practices are well positioned to act as the “accountable care organizations” called for by the new health care reform law, signed by President Obama in March.

The law authorizes the Medicare program to contract with certain health care providers—most likely a combination of a physician group and a hospital—to come up with quality-improving and cost-saving methods. Then Medicare would give some of the savings as a bonus payment to the doctors and hospitals.

"The findings of this study by [the Dartmouth researchers] suggest that large multispecialty medical groups already provide higher-quality, lower-cost care, and would be well positioned to assume the role of accountable care organizations,” Health Affairs editor Susan Dentzer said in a statement. “By continuing to provide higher quality care at lower cost, they could go a long way toward bending the cost curve and achieving other goals of health system reform."

ADVERTISEMENT

Post a comment to this story

COMMENTS POLICY
We reserve the right to remove any post that we feel is obscene, profane, vulgar, racist, sexually explicit, abusive, or hateful.
 
You are legally responsible for what you post and your anonymity is not guaranteed.
 
Posts that insult, defame, threaten, harass or abuse other readers or people mentioned in IBJ editorial content are also subject to removal. Please respect the privacy of individuals and refrain from posting personal information.
 
No solicitations, spamming or advertisements are allowed. Readers may post links to other informational websites that are relevant to the topic at hand, but please do not link to objectionable material.
 
We may remove messages that are unrelated to the topic, encourage illegal activity, use all capital letters or are unreadable.
 

Messages that are flagged by readers as objectionable will be reviewed and may or may not be removed. Please do not flag a post simply because you disagree with it.

Sponsored by
ADVERTISEMENT

facebook - twitter on Facebook & Twitter

Follow on TwitterFollow IBJ on Facebook:
Follow on TwitterFollow IBJ's Tweets on these topics:
 
Subscribe to IBJ
  1. I took Bruce's comments to highlight a glaring issue when it comes to a state's image, and therefore its overall branding. An example is Michigan vs. Indiana. Michigan has done an excellent job of following through on its branding strategy around "Pure Michigan", even down to the detail of the rest stops. Since a state's branding is often targeted to visitors, it makes sense that rest stops, being that point of first impression, should be significant. It is clear that Indiana doesn't care as much about the impression it gives visitors even though our branding as the Crossroads of America does place importance on travel. Bruce's point is quite logical and accurate.

  2. I appreciated the article. I guess I have become so accustomed to making my "pit stops" at places where I can ALSO get gasoline and something hot to eat, that I hardly even notice public rest stops anymore. That said, I do concur with the rationale that our rest stops (if we are to have them at all) can and should be both fiscally-responsible AND designed to make a positive impression about our state.

  3. I don't know about the rest of you but I only stop at these places for one reason, and it's not to picnic. I move trucks for dealers and have been to rest areas in most all 48 lower states. Some of ours need upgrading no doubt. Many states rest areas are much worse than ours. In the rest area on I-70 just past Richmond truckers have to hike about a quarter of a mile. When I stop I;m generally in a bit of a hurry. Convenience,not beauty, is a primary concern.

  4. Community Hospital is the only system to not have layoffs? That is not true. Because I was one of the people who was laid off from East. And all of the LPN's have been laid off. Just because their layoffs were not announced or done all together does not mean people did not lose their jobs. They cherry-picked people from departments one by one. But you add them all up and it's several hundred. And East has had a dramatic drop I in patient beds from 800 to around 125. I know because I worked there for 30 years.

  5. I have obtained my 6 gallon badge for my donation of A Positive blood. I'm sorry to hear that my donation was nothing but a profit center for the Indiana Blood Center.

ADVERTISEMENT