Page 54 - 2013 Hospitals/Systems Digest US.NMH.13.02.007
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54
HOSPI TALS/SYSTEMS WI TH MEDICAL GROUP PRACT ICES
HOSPITALS/SYSTEMS DIGEST 2013
SANOFI / MANAGED CARE DIGEST SERIES
®
/ WHERE INFORMATION BECOMES INTELLIGENCE.
™
Data source: IMS Health © 2013
Key Takeaway
Under pressure to streamline patient care and distinguish themselves in a competitive environment,
medical groups may be expanding their services. However, this may result in higher costs for patients
and payers alike. Medicare physician payments, for example, have consistently topped the annual
target set by the Centers for Medicare and Medicaid Services, known as the Sustainable Growth
Rate formula. This triggered annual cuts in Medicare physician payments. These cuts have yet to be
implemented, resulting in a $300 billion-plus deficit in the Medicare physician payment system.
1
• For seven of the eight group specialties profiled
(family practice excepted), multispecialty
practices were more likely than their single-
specialty peers to perform surgery in 2012.
• For example, just 6.9% of groups focused
exclusively on cardiology performed surgery
in 2012, compared with 68.5% of multispecialty
practices with a cardiology component.
Rising Shares of Groups Offer Surgery, Lab and Imaging Services
• The percentages of medical group practices
that performed surgery, offered clinical labs or
provided imaging services increased between
2011 and 2012, though only fractionally.
• The share of oncology practices that performed
surgery grew in 2012, to 76.0% from 74.4% the
prior year. Such practices also were more likely
to offer clinical labs or imaging services in 2012.
UT I L I ZAT ION
percentage of medical group practices, by type of service
Perform Surgery
Offer Clinical Labs
Provide Imaging
SPECIALTY
2011
2012
2011
2012
2011
2012
Cardiology
40.4%
43.7%
57.6%
57.9%
73.5%
74.7%
Family Practice
74.8
75.4
70.6
70.4
74.0
74.7
General Surgery
82.5
83.7
58.4
61.9
69.8
72.2
Internal Medicine
58.5
59.7
71.8
72.1
70.4
71.5
OB/GYN
70.2
70.9
62.8
63.2
80.3
80.6
Oncology
74.4
76.0
83.9
85.4
79.8
81.1
Orthopedics
52.2
53.5
43.1
45.3
83.5
83.8
Pediatrics
57.7
58.8
66.2
67.2
62.3
63.7
OVERALL AVERAGE
54.3% 54.7% 49.5% 49.8% 64.1% 64.5%
0%
25%
50%
75%
100%
Percentage of Groups
Cardiology
OB/GYN
Family
Practice
General
Surgery
Internal
Medicine
Oncology Orthopedics Pediatrics
6.9%
68.5%
76.9% 74.4%
80.1%
84.7%
31.8%
67.0% 67.3%
73.0%
44.4%
76.7%
34.3%
64.4%
38.1%
69.9%
Single Specialty
Multispecialty
PERCENTAGE OF MEDICAL GROUP PRACTICES THAT PERFORM SURGERY, 2012
1
Medical Group Management Association. (2011). Medicare Physician Reimbursement. Retrieved from
Surgery Offerings Are More Common Among Multispecialty Medical Groups
