Down on the Farm The Attack on Physician Ownership

2008 Outlook for Physician Owners

The rate of hospital acquisitions of practices is once again on the rise and increasing numbers of physicians, especially primary care providers, are no longer choosing to practice in traditional organizations such as solo and independent small group practices. This, in turn affects the ability of specialists and surgeons to develop a referral structure and retain a sufficient patient base to maintain the viability of their practices. Additionally, physician owned ASCs and specialty providers are expected to face increasingly strict federal and state regulations in 2008 which will continue to act as a barrier to new and competing market entrants.

Physician owners are a diverse group with competing interests among specialties and little overall cohesiveness. Nonetheless, hospital oligopoly players consider them a single group, i.e., physicians receiving any ownership benefits of ASTC revenue are targeted by the hospital lobby juggernaut. To survive as meaningful players in the healthcare marketplace, physician owners must quickly come together, united by the need to withstand well organized and coordinated threat to their very existence.

Consequently, a thorough understanding of the ever-changing regulatory, reimbursement, competitive and technological environment affecting physicians financial relationships with payors and patients is essential, as well as staying aware of legislative efforts and lobbying attacks aimed at physician owners—in particular the evolving and increasingly expansive attacks at the state level. It is only by presenting a unified front that physician owners will be effective in their advocacy efforts to combat the desire of oligopoly hospital interests to monopolize ASTC revenue streams.

Robert James Cimasi, MHA, ASA, CBA, AVA, CM&AA, CMP, is president of Health Capital Consultants, a healthcare and financial economic consulting firm headquartered in St. Louis. Cimasi can be reached at rcimasi@healthcapital.com.