Patient Concerns Not Compromised When Practices Switch Ownership From Physicians to Systems

Physician-owned practices that switch to ownership by a hospital, health care system or insurance company do not become significantly less responsive to patient concerns, according to an AHRQ-funded study in Health Services Research. Researchers collected data from three nationally representative surveys of about 900 physician organizations. Forty-minute interviews were conducted with medical directors, presidents or chief executive officers. The study found that ownership transitions may, in fact, modestly increase practices’ responsiveness to patient concerns. Researchers concluded the findings may have important implications related to implementation of the Medicare Access and Children’s Health Insurance Program Reauthorization Act of 2015, which established value-based payment incentives and quality of care targets. This research was funded by AHRQ’s Comparative Health System Performance Initiative, which studies how health care delivery systems promote evidence-based practices and patient-centered outcomes research in delivering care. Access the abstract.

2017 Nov 16. doi: 10.1111/1475-6773.12804. [Epub ahead of print]

Physician Practice Transitions to System Ownership Do Not Result in Diminished Practice Responsiveness to Patients.

Poon BY1, Shortell S1, Rodriguez HP1.

Author information

Abstract

OBJECTIVE:

To examine the extent to which physician-to-system ownership transitions are associated with declines in practice-reported patient responsiveness (PRPR).

DATA SOURCES:

A longitudinal cohort of practices (n = 897) from the National Survey of Large Physician Organizations/National Survey of Small- and Medium-Sized Physician Organizations (2006/08) and the National Survey of All-Size Physician Organizations (2012/13).

STUDY DESIGN:

Multivariable regression estimated the effect of ownership on changes in PRPR, controlling for practice size, specialty composition, other practice, and market characteristics.

DATA COLLECTION/EXTRACTION METHODS:

Data were collected from three nationally representative surveys of physician organizations consisting of 40-minute interviews with the medical director, president, or chief executive officer.

PRINCIPAL FINDINGS:

Nine percent of organizations transitioned to system ownership. Compared to practices that were continuously physician-owned, practices that switched to system ownership did not have significantly lower PRPR at baseline but continuously system-owned practices did. Transitions to system ownership were associated with increased PRPR compared to continuously physician ownership. Increased practice size and changes in specialty composition, however, were associated with diminished PRPR.

CONCLUSIONS:

Practices can maintain or improve strategies to address patient concerns when transferring ownership to systems with careful attention to the impact of increased size and changes in specialty composition.