医院和私募股权相关的专科医生谈判的价格高于独立医生
Alexander P Philips1, Nandita Radhakrishnan2, Christopher M Whaley3
1Alexander P. Philips, Brown University, Providence, Rhode Island.
Health affairs (Project Hope)
|October 6, 2025
概括
医生实践与医院和私募股权 (PE) 的整合增加了医疗保健成本. 与独立实践相比,医院雇佣的专家收取心脏病和胃肠病服务的价格要高得多.
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健政策 医疗保健政策
- 医疗实践管理 医疗实践管理
背景情况:
- 在医院和私募股权 (PE) 公司等企业实体下,医生实践的日益整合正在重塑医疗保健服务.
- 截至2023年,超过75%的医生受雇于这些企业实体,影响实践动态和患者成本.
- 了解不同所有权模式的财务影响对于医疗保健政策和成本控制至关重要.
研究的目的:
- 分析专家医生之间的实践附属模式.
- 调查专业实践 (医院,PE或独立) 与心脏病学和胃肠病学服务的商业价格之间的联系.
- 估计因降低价格差异而产生的潜在成本节约.
主要方法:
- 检查了2023年专家医生的实践附属数据.
- 对心脏病和胃肠病手术的谈判商业价格进行了比较,涉及不同的附属类型:医院雇员,PE附属和独立实践.
- 根据价格与独立实践的等价计算出商业医疗保健支出的潜在减少.
主要成果:
- 在2023年,大多数专家都在医院工作 (72%的心脏病学家,57%的胃肠病学家).
- 与独立专家相比,医院附属专家的心脏病治疗费用比独立专家高16.3%,胃肠病治疗费用比独立专家高20.7%.
- 与PE关联的专家收取心脏病学服务的费用增加了6.0%,胃肠病学服务的费用增加了10.0%.
结论:
- 医生实践的企业整合导致医疗保健价格上.
- 转向独立实践定价可以节省数十亿美元的商业医疗保健支出 (心脏病学29亿美元,胃肠病学156万美元).
- 对所有权和定价的反断执法和透明度对于控制成本和确保患者获得优质护理至关重要.
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