10 Ways Market Changes Will Reshape Physician Practices

Laura P. Jacobs, MPH


November 07, 2012

In This Article

High Expectations of Physicians

8. Innovation Is Rewarded...and Expected

CMMI has awarded grants to organizations to explore new ways to coordinate care and serve complex patients. They are also partnering with payers and primary care providers as part of the Comprehensive Primary Care Initiative. PPACA provided $10 billion in funding for innovation, and CMMI is continually identifying initiatives that it will fund to spark innovation in care delivery and payment models. Care model redesign, particularly in primary care, is now an area some payers are supporting with up-front payments.

In the near future, providing care in innovative ways that make the best use of technology, assure coordinated care, and improve patients' health status will be an expectation. Watch out for other disruptive innovators that are not traditional healthcare providers (eg, technology companies, retail services, etc.); if providers fail to lead the development of new models of care...someone else will.

9. Workforce Expectations and New Models of Care

PPACA acknowledges the need for expanding training programs in primary care and general surgery by including funds for these as well as supporting training for medical homes and team management of chronic disease. But in most markets there is still a shortage of primary care physicians to serve the continually expanding expectations: being the first point of access for patients, coordinating care, managing chronic disease, not to mention the newly insured population coming in 2014.

To compound the shortage, many regions face an aging physician community and incoming physicians who want more work-life balance, fewer work hours, and greater security than can be found in private, small practices. Physicians and health systems must evaluate their care delivery models to identify expanded roles for advanced practice nurses and even nonlicensed staff to assure that physicians' time is most effectively used. Further, evaluating group structure, compensation models, and recruitment approaches will be required to meet both work force expectations and community need.

10. The Rising Expectations of Consumers

The Baby Boom generation can be described as a "perfect storm" as far as healthcare consumerism is concerned. Aging baby boomers are increasing their demand for healthcare services. They have high expectations for what medical care can do, and they engage in increasing use of the Internet and other electronic devices to manage their lives. They lack the reverence for physicians their parents had, and they harbor increasing price sensitivity due to the increase in high deductible plans or health savings accounts.

This combination makes them the most challenging -- and most plentiful -- consumers for physicians to deal with. The PPACA includes many references to expectations for physicians to be "patient centric."

It is crucial that physicians and their practice administrators evaluate how truly responsive they are to meeting the needs of their patients -- on terms patients are increasingly expecting.