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General HBP National Trends

Legislation Affecting Hospital-Based Physicians

  • Bundled payments mandated in 2024 impacting hospital-based providers. No Surprise Billing Act. Elimination of out of network healthcare charges  - effective January 2022. Impact will be lower revenue for HBP provider groups forcing higher subsidies. 

  • California legislation mandates W-2 employment. Eliminates 1099 travelers. Other states have made independent practice waivers permanent.  Increasing labor costs, maybe impacting labor shortages

  • President Biden’s Executive Order Sec. 5(g) signed July 9 2021, asks FTC to curtail or eliminate use of noncompete clauses


How is Consolidation Affecting Hospital-Based Physicians

  • Consolidation of HBP companies and practices are projected to continue for rate and contract leverage with providers.


Labor Shortages in Anesthesia, Radiology, Critical Care, Hospital Medicine

  • Severe labor shortage is continuing and may accelerate in all three services including midlevel’s due to retirements and COVID burnout at.

  • RN Nursing shortages are impacting ER throughout the country impacting hospital capabilities. 

  • On-demand staffing models may evolve over time.

  • Exception to the HBP labor shortage is Emergency Medicine.  American College of Emergency Medicine is predicting a large surplus (12,000) of Board Certified EM Physicians by 2030

Expansion of Use of CRNAs, NPs, and PAs in Hospital-Based Practices 

  • Midlevels use is expanding  to lower costs and leverage physician numbers.


Physician Employment: What is the True Cost?

  • Important to recognize the true cost of employment


How Payors are Negotiating with Hospital-Based Physicians

  • Third party payors are reducing rates and canceling contracts if not accepted. 

  • Payors are gaining leverage. 


You Are Not Your Own Customer

  • What this means for Hospital-based Physicians and groups


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