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THE CASE OF THE VANISHING INDEPENDENT DOCTOR

Why there are fewer physicians in independent practice than ever

ANALYSIS

3% of independent physicians have opted out of Medicare programs.

The Accenture survey shows 3 percent of independent physicians have opted out of Medicare programs. This comes as the patient insurance mix for Medicare is also changing. Nearly a third of those age 65 and older are opting for Medicare Advantage plans managed by commercial insurers over traditional Medicare. Medicare supplemental insurance (Medigap) enrollment is also on the rise.

Some independent physicians are experimenting with other models to remain competitive. The Accenture survey shows that:

  • Nearly a fifth (17 percent) of independents report they are participating in accountable care organizations.

  • Seven percent are participating in patient-centered medical homes.

In other cases, physicians are offering ancillary or subscription-based services to remain competitive. For example, One Medical offers same-day appointments, online prescriptions and email access to doctors—all for approximately $150 to $200 a year.

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RECOMMENDATIONS

Practices that are independent today won’t look like the same practices in the future. Since independent practice is no longer business as usual, physicians must establish a competitive business model that is as unique as the market they now serve.

How the physician employment trend and its implications will unfold remains to be seen. Other clinical care providers—local hospitals, integrated health systems and even retail clinics—are likely to experience a shift in patient populations, a new payer mix and healthcare delivery challenges as it evolves.

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