What's the penetrance of large, corporate management groups in hospitalist medicine?

[Money Moniker]

These things are a cancer that is absolutely destroying EM and anesthesia, but I have no idea how common they are for hospitalists. Are PP groups still the rule, or are most markets completely dominated by CMGs?

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[laserbeam]

I work as a hospitalist employed by the hospital which is a large health system. The management is also corporate management. It is unfortunate that hospitalists can only be employees, no matter by who, as our billing is not sufficient to support ourselves.

There is a big consolidation going on in my area. It appears that many specialists will become employees soon. Medicine is a fallen profession, I think.

 

[VA Hopeful Dr]

It is unfortunate that hospitalists can only be employees, no matter by who, as our billing is not sufficient to support ourselves.

Who told you that?

It depends on payer mix, but I know of a fair number of Private Practice hospitalist groups.

 

[laserbeam]

Who told you that?

It depends on payer mix, but I know of a fair number of Private Practice hospitalist groups.

Per Society of Hospital Medicine State of Hospital Medicine Report in 2016, median collection for professional charges is $213253 which is lower than what we earn, median amount of financial support per FTE physician is $157535, 96.3% of hospital medicine groups receive financial support in addition to professional fee revenue. However, our value is certainly more than the RVUs that we can collect so hospitals are paying.

My previous job was managed by a big name corporate management group. The hospital is trying so hard to get rid of it and hire their own.

 

[VA Hopeful Dr]

Per Society of Hospital Medicine State of Hospital Medicine Report in 2016, median collection for professional charges is $213253 which is lower than what we earn, median amount of financial support per FTE physician is $157535, 96.3% of hospital medicine groups receive financial support in addition to professional fee revenue. However, our value is certainly more than the RVUs that we can collect so hospitals are paying.

My previous job was managed by a big name corporate management group. The hospital is trying so hard to get rid of it and hire their own.

Seriously? That's surprising given what Medicare pays, much less private insurers.

Let's assume 14 shifts per month. Each day you have 12 existing patients all billed level 2. Medicare pays $75 for each. So your daily existing patients earn you $900 on the day. Let's also say you have 4 new patients all level 3. Medicare pays $200 for that, so add $800 to the day for a grand total of $1700. Multiple that by 14 and you get $23,800 per month which is $285k per year.

 

[scpod]

Seriously? That's surprising given what Medicare pays, much less private insurers.

Let's assume 14 shifts per month. Each day you have 12 existing patients all billed level 2. Medicare pays $75 for each. So your daily existing patients earn you $900 on the day. Let's also say you have 4 new patients all level 3. Medicare pays $200 for that, so add $800 to the day for a grand total of $1700. Multiple that by 14 and you get $23,800 per month which is $285k per year.

But 4 of my patients are Medicaid, and that pays very little. Three patients are uninsured. Two have UHC and they just denied the inpatient stay altogether.

 

[VA Hopeful Dr]

But 4 of my patients are Medicaid, and that pays very little. Three patients are uninsured. Two have UHC and they just denied the inpatient stay altogether.

Hence why I said payer mix matters.

This isn't entirely me pulling this out of my backside. My wife used to be a hospitalist, and after her first three years when the group went to renegotiate their contracts the director looked at their billing and realized they were earning the hospital a lot more money than they were getting paid including benefits. The entire group got a $35,000 raise.