Thriving in this new healthcare environment demands both significant capital investment and the ability to navigate increasingly complex reporting requirements and financial arrangements. These factors, combined with a new generation of nephrologists with different expectations for their work-life balance, are prompting many nephrologists to seek a new way of doing business, including joining larger organizations.

Laying a foundation for the future


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According to the Physicians Advocacy Institute (PAI), the number of employed physicians grew by 46,000 nationwide from 2012-2015, with the percentage of hospital-employed physicians increasing almost 50% from July 2012 to July 2015.

The trend is expected to continue. Uncertainty clouds many aspects of healthcare today, including how to cover uninsured Americans. However, the federal government and private insurers are aligned in their focus to better manage care for patients with chronic kidney disease and end-stage renal disease. These patients consume a disproportionate share of resources, to the tune of more than $30 billion a year. Regardless of what happens with the Affordable Care Act, integrated care and risk-based agreements are here to stay.

In addition to the significant capital investment required, these new payment arrangements pose other challenges for many doctors, the majority of whom have little to no formal training in busi­ness or business principles. After all, historic fee-for-service reimbursement models did not require physicians to have a sophisticated understanding of the business of practice. Further, payment structures employed by the federal government and private insurers increasingly favor integrated health systems, making it more difficult for independent physicians to compete.

Times of change are challenging, but there are viable options for partnerships that will put nephrologists on a sustainable path for the future. Physicians should consider partners who are not only better equipped to participate in integrated care models but who can also more easily absorb administrative costs to comply with regulatory and reporting requirements. Having access to a larger infrastructure allows administrative experts to manage contracts and reporting requirements, helping physicians, who may already be spread thin, to continue to focus on their top priority: caring for their patients.

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Healthcare will always be local, and patients will always need nephrologists to meet their needs wherever they are. However, today’s environment requires nephrologists to evaluate how best to partner to sustain their medical practices into the future. Now is a good time to take stock of your practice and reflect on your short- and long-term goals. This exercise will not only help doctors address future challenges, but it will also better position them to identify solutions. In future articles, we will describe different practice options, as well as how to evaluate them in light of your personal and financial priorities. With increased competition and costs, you can’t afford not to.

Robert Provenzano, MD, is vice president for medical affairs at DaVita Kidney Care in Denver. He also is on the editorial advisory board of Renal & Urology News

Mark Hovermann, MBA, is Senior Director, Corporate Development.

Lanny Teets is Director, Transactions & Growth Initiatives, at Nephrology Practice Solutions.

This article originally appeared on Medical Bag