Physicians employed by health systems or private equity groups staff most emergency department visits, according to a study published in the Annals of Emergency Medicine. Groups with majority physician ownership staffed less than half of ED visits that were analyzed.
“The rapid pace of consolidation across emergency medicine raises critical questions about care quality and physician employment,” said Dr. Angela G. Cai, lead study author and assistant professor of clinical emergency medicine at the University of Pennsylvania. “A shared understanding of market trends can inform efforts across the country to improve physician work conditions and strengthen care delivery.”
Health system-owned groups staffed one-third of all emergency visits, the analysis of nearly 4,000 hospital emergency departments found. Nearly 1 in 4 visits were staffed by physicians in private equity-owned groups. Regional clinician partnership-owned groups accounted for 21% of visits, followed by national clinician-owned partnerships groups (13.4%) and single-site clinician partnership-owned groups (8%). These findings show that less than half of emergency visits are staffed by majority physician-owned employers.
Researchers also looked at market concentration trends. Economic and regulatory pressures have driven physician practice consolidation, including the possibility of economies of scale, greater payment negotiating leverage, access to costly resources and regulatory and administrative requirements. Increased corporate investment in health care, including physician groups, has come from private investors, most notably private equity.
The emergency medicine market is highly concentrated regionally, as well as within the private equity and national partnership ownership categories. In the private equity ownership category, 93% of all ED visits were seen by physicians working for three employers. Regional concentration is high, with 84% of 306 hospital referral regions nationwide qualified as highly concentrated.
A lack of transparency in practice ownership has impaired the ability to understand market trends and health outcomes, the report said. At the same time, emergency physicians continue to raise strong concerns about care quality and workplace satisfaction as consolidation increases.
“This study does the foundational work to define market trends, that non-physician owned groups staff most emergency department visits and the emergency physician employer market is highly concentrated,” Cai said. “Researchers and policymakers have a critical opportunity to connect these trends to patient outcomes and physician employment. Our findings can inform and emphasize the need for policy changes to improve practice environments and enhance patient care.”
© Arc, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to TMSalesOperations@arc-network.com. For more information visit Asset & Logo Licensing.