MedScape reports that “Of the 3,120 searches for physicians, nurse practitioners (NPs), and physician assistants (PAs) the firm handled between April 2014 and March 2015, 51 percent were on behalf of hospital and hospital-owned medical groups, a big drop from 64 percent for the previous 2 years. It was the first decline since 2003-2004, when hospitals accounted for 11 percent of the company’s searches….”
Merritt Hawkins cited the accelerating pace of hospital closures, especially in rural areas as at least one reason for the drop.
It also noted that budget sequestration and lower federal Disproportionate Share (DSH) payments have taken a toll, along with many states’ refusal to expand their Medicaid programs, designed to offset the DSH cuts.
Hospitals, of course, always face competition from independent group practices, Federally Qualified Health Centers, academic medical centers, urgent-care centers, and solo practices.
“It’s more of a diversified market,” said Travis Singleton, senior vice president of Merritt Hawkins, told Medscape.
Mr. Singleton, however, doesn’t think hospital demand for physicians has peaked. More likely, it has simply paused, he told the publication. “I won’t be surprised if it goes back up.”
He told Medscape that’s because the recent Supreme Court decision to uphold premium subsidies in all states under the Affordable Care Act (ACA) has removed the last major barrier to implementing the law. So the healthcare industry will continue to shift from independent providers to integrated providers. In other words, expect yet more hospital-physician “togetherness”.
In any event, the exits of self-employed physicians continue apace. Medscape said that “of all the positions that various healthcare organizations asked Merritt Hawkins to fill, 95 percent last year were for employed physicians, nurse practitioners, or physician assistants, up from roughly 90 percent the year before.
Merritt Hawkins also noted that it continues to be an overwhelmingly fee-for-service world and suggests that this will continue for a l0ng time to come.