Physician Practice Affiliation Drives Site of Care Cost Differentials: An Opportunity to Reduce Healthcare Expenditures
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View abstract on PubMed
Summary
This summary is machine-generated.Physician affiliation with private equity (PE) groups, rather than hospitals, is linked to higher healthcare costs. Site of care significantly impacts procedure prices, with hospital settings being more expensive.
Area Of Science
- Health Economics
- Healthcare Policy
- Physician Practice Management
Background
- Increasing physician migration from independent practice to larger entities like hospitals, payers, and management services organizations (MSOs).
- Limited data exists on how various physician affiliation models influence healthcare costs.
- Private equity (PE) involvement in healthcare is a growing area of concern.
Purpose Of The Study
- To investigate the relationship between physician affiliation models, site of care (SOC), and the cost of care.
- To analyze these relationships for high-volume procedures in procedure-intensive specialties across Medicare and commercial insurance.
Main Methods
- Examined data on provider affiliation models and site of care for specific high-volume procedures.
- Compared costs for Medicare and commercial insurance beneficiaries.
- Analyzed the impact of SOC on procedure unit prices.
Main Results
- Physicians affiliated with hospitals were least likely to use lower-cost care settings.
- Physicians affiliated with private equity (PE) were most likely to use higher-cost care settings.
- Site of care significantly impacts procedure unit prices, with hospital-based settings consistently more expensive.
Conclusions
- Physician affiliation models and associated site of care cost differentials substantially increase healthcare expenditures.
- Medicare cost differentials are influenced by existing statutes and regulations.
- Policy interventions, such as site-neutral payments, are necessary to address the financial impact of physician practice migration.
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