Health Care Monitor Survey Offers Look at the State of the Practice of Medicine in NJ

The vast majority of New Jersey physicians (89.89 percent) believe that the changing healthcare environment has negatively impacted their role as a physician, according to a just-released survey.  Of those, more than 86 percemtsaid that they felt an increased administrative burden as a result of the changing environment, while 60.34 percent each said that it also led to reduced time spent with patients, reduced or increased reimbursement, and a greater expenditure on technology, revealed Brach Eichler’s 2014 New Jersey Health Care Monitor. Brach Eichler conducted the statewide annual survey among physicians, including solo practitioners, members of a group practice or employees of a health care facility, in November and December 2014.

In addition, nearly one in four (39.39 percent) have an unfavorable or very unfavorable outlook for their medical practice in 2015, while only 22.73 percent reported a favorable outlook.  No respondent reported a very favorable view for 2015. These findings underscore a declining sense of optimism from last year, when 38 percent reported an unfavorable view and more than 26 percent reported a favorable outlook for 2014.

“New Jersey has always been a challenging state for business and industry due to a highly regulated and very competitive environment.  Physicians and the practice of medicine are no exception,” said John D. Fanburg, chair of the health law practice at Brach Eichler. “In fact, New Jersey is considered a bellwether for the national healthcare business climate in many ways. These survey findings reflect a growing level of concern among providers today across the US who are feeling pressured to divert increasingly more of their attention to running their business from tending to their patients.”

More than half (53 percent) of physicians are considering changing their practice structure in the near future (versus 45.5 percent last year).  While the reasons vary somewhat from the fact that competing organizations are integrating to the need to reduce expenses, increase cash flow and reduce operational inefficiencies within the practice, as well as bolster market share, “it’s clear that physicians are looking for ways to better manage their practices in an effort to remain viable under these volatile business conditions,” noted Joseph Gorrell, a health care partner at Brach Eichler.

Among the New Jersey Health Care Monitor’s other findings:

  • Of the 43.94 percent respondents that reported changing their practice structure in 2014, 41.9 percent hired other practitioners, 38.71 percent integrated their practice with another healthcare organization, and nearly 13 percent retired.
  • Only 3.03 percent said their income increased substantially in 2014 over 2013; far more (37.88 percent ) said it decreased substantially and nearly 60 percent said it remained the same.
  • These findings were in line what respondents also had to say about reimbursement rates in 2014 — 53.03 percent said they decreased from 2013, only 6.06 percent said they increased, and 40.91 said they stayed the same.
  • As in 2013, Accountable Care Organizations (ACOs) are still not prevalent here in New Jersey, with only 28.7 percent saying they are a member (24.1 percent said they joined last year).  Of those that joined only 5.41 percent report any benefits as a result.
  • Medical Home Models are also not the norm here, with only 10.61 percent saying they have been approached to enter into a contract with one. Further, the vast majority (more than 95 percent) don’t expect to derive any benefit from contracting with one either.
  • In a slight shift from 2013, when many practitioners though that ACA and the 2012 elections  negatively impacted their outlook for their medical practice in 2013, more practitioners in 2014 felt positive (10.61 percent) or do not foresee any impact on their medical practice (56.06 percent) as a result of the Affordable Care Act (ACA).

“While 2014 experienced a small growth in ACO membership in New Jersey, the predominant  trend in our State continued to be the consolidation of medical practices into hospital-affiliated practices and large multi-specialty groups,” said Gorrell.

“The healthcare environment is very dynamic right now as providers continue to face major decisions about their practice structure, compliance and regulatory matters, and in general, sustaining a financially-sound business model that delivers the highest quality medical care.  The New Jersey Health Care Monitor reveals just how New Jersey’s physicians view these growing demands on their time, and for many, it’s made the practice of medicine challenging at times.  But change breeds opportunity, and we expect that the evolution of the healthcare business will reveal new business models that will serve both the doctor and patient well,” said Fanburg.

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