Health Reform and the Decline of Physician Private Practice

November 14, 2012

Health Reform and the Decline of Physician Private Practice

A white paper examining the effects of The Patient Protection and Affordable Care Act on physician practices in the United States, including results of Physicians and Health Reform, a survey of 100,000 physicians.

Executive Summary

Like society itself, medical practice has been evolving rapidly in the United States over the last 50 years, in response to technological, economic, demographic, political and related influences. Passage of the Patient Protection and Affordable Care Act (“health reform”) promises to accelerate this evolution in a variety of significant ways.

The Physicians Foundation called upon Merritt Hawkins and an Advisory Panel of healthcare experts to assess how health reform is likely to affect the ways in which physicians practice in the United States. This White Paper reflects the results of Merritt Hawkins’ and the Advisory Panel’s analysis. Meeting over a period of two days, the Advisory Panel delineated some general themes and projections, concluding: 

1) Health reform is comprised of two elements: “Informal reform,” (i.e., societal and economic trends exerting pressure on the current healthcare system independent of the Patient Protection and Affordable Care Act), and “formal reform,” (i.e., the provisions contained in the Act itself). 

2) The current iteration of health reform, both formal and informal, will have a transformative effect on the healthcare system. This time, reform will not be a “false dawn” analogous to the health reform movement of the 1990s, but will usher in substantive and lasting changes. 

3) The independent, private physician practice model will be largely, though not uniformly, replaced. 

4) Most physicians will be compelled to consolidate with other practitioners, become hospital employees, or align with large hospitals and health systems for capital, administrative and technical resources.