Physician perceptions of productivity changes post health system employment: A mixed method case study.

摘要

Since 1985, health systems such as hospitals, clinics, diagnostic laboratories, and insurance plans have purchased physician practices to control market share, add value to their networks, secure physician supply, increase patient volume and referrals, and supersede value-based health care reimbursement. Physicians are also leaving private practice and joining health systems as compensated employees to counter reduced Medicare fee schedules, increased practice overhead costs, burnout from self-employment, and the desire for job security in the age of healthcare reform and uncertainty. However, physician productivity significantly declined after leaving practice and joining a health system. The purpose of this mixed method, sequential exploratory case study was to explore physicians' perspectives of their productivity changes, if any, after a health system purchased their private practices. Semi-structured interviews gained the physicians' perspectives of changes to production following the purchase of their practices. This data was supported by worked relative value units and cash collection data to demonstrate changes in production. Five themes emerged from the results. Physicians sold their practice due to government influences. Physicians sold their practice due to human factor influences. There was a perceived decline in productivity associated with the acquisition. There were no perceived changes in productivity post-acquisition. There were perceived changes in clinic operations post-acquisition.