The Tangled Hospital-Physician Relationship

Together, hospital and physician services account for more than half of national health spending. In its 2014 National Health Expenditures estimates, the Centers for Medicare and Medicaid Services’ actuaries make the hospital (nearly $1 trillion) and physician practice (nearly $600 billion) sectors appear to be independent and non-overlapping. This is an optical illusion. Hospitals and physicians are, in day-to-day practice, hopelessly intertwined. And while power appears to be shifting from physicians to hospitals with the increasing salaried employment of physicians, appearances can be deceiving. This post discusses the economic power balance between hospitals and physician communities, and the policy levers that influence this complex relationship — a relationship that is evolving in a way that could increase financial pressures on both hospitals and the American health system. Physicians and hospitals must intimately collaborate or care does not get delivered. At the same time, hospitals and physicians directly compete in surgery, imaging, and other ambulatory services. In this relationship of simultaneous competition and interdependency, the borderline between hospitals and physicians is fraught both with economic conflict and moral/legal risk. Conflict with physicians over contracts, practice prerogatives, and scope of professional practice poses one of the single most significant career threats to hospital administrators. Hospital executive colleagues have comm...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Costs and Spending Featured Health Professionals Hospitals Medicare Payment Policy Population Health Quality ACOs Bundled Payments EMTALA MACRA Medicare Part B Physicians Source Type: blogs