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Gonnif, would your appraisal change at all if the question were about starting a group practice? Something like a 5-10 physician outpatient center.
My long time personnal IM ran an established 10 person practice that was decimated in the past 5 years because of this and he had to go to one of the corporate spots as an individualGonnif, would your appraisal change at all if the question were about starting a group practice? Something like a 5-10 physician outpatient center.
Generally, Hospitals and large groups like Prohealth have significantly more leverage when negotiating reimbursements from insurance companiesFrom what I've heard a lot of issues stem from reimbursement rates for the hospitals vs private practice (hospitals get better reimbursements, so it can be difficult to stay in private practice). Do any of the actual physicians or medical gurus know more about this?
That thought is rational and logical. this is politics and turf.huh... that is an interesting dynamic for sure. I applied to all 3 of those places without realizing that, and they're all mostly (kind of ish) in the same tier. Though, it's not clear why there would be pushback against Hofstra as it is in a different location, and I don't see how adding another med school in the NYC/Long Island area would make that much of a difference in terms of admissions.
Can you comment on practices that have exclusive contract to staff certain hospital depts? For example, the smaller hospital system hase essentially outsourced its ER to a private practice which acts as staff? Is this a widespread organizational structure?IRT: contracts and reimbursement
The reason so many PP have poor contracts is that:
1) they don't negotiate
2) they don't offer a service that others can't/don't cover as many lives etc
Our contracts are excellent but it didn't come without being proactive, renegotiating and showing the private payers that they need us. Surgery is still open to PP.
However, I will concede that a SOLO practice is hard to do. I know some that do it but why not have a partner? The fixed costs (electricity, mortgage/lease, employee salaries, etc. are cheaper when divided by 2 or more). Plus call/vacation is a nightmare by yourself.
I can't comment on how widespread it is, but I've certainly seen it.Can you comment on practices that have exclusive contract to staff certain hospital depts? For example, the smaller hospital system hase essentially outsourced its ER to a private practice which acts as staff? Is this a widespread organizational structure?
There is no difference. Medicare rates are set and do not differ whether you have a hospital owned or private practice.Can anyone comment on the specific Medicare/Medicaid reimbursement for private vs hospital practices? It seems like there may be some leeway with private insurance depending on how well you negotiate, but would Medicare/Medicaid be set at the national level?