Legislation Affecting Hospital-Based Physicians

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• 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

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• 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

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• 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

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

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

 

Physician Employment: What is the True Cost?

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• Important to recognize the true cost of employment

 

How Payors are Negotiating with Hospital-Based Physicians

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• 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