Taking a crystal ball and trying to see the future when the political environment is hyper charged is very difficult. However, here is one take on the impact of the Affordable Care Act (ACA) on doctors and other providers in the physician recruiting field…
Other Providers
- The Valued Based Purchasing model will motivate hospitals to meet or exceed benchmarks. Those who do not meet benchmarks will be punished.
- Expanded coverage should mean more work for primary care doctors and possibly less need in Emergency Medicine since patients will be more proactive.
- General consensus is that the short term impact on hospitals is that there will be more patients, more billing, and more income.
- Over the long term there is concern about the sustainability of this plan.
- Moody’s, Fitch, Standard and Poor’s agree that the short term is positive while Standard and Poor’s are less optimistic about the long term.
Doctors
- The Primary Care shortage is already estimated at 15,000 doctors. Expanded coverage could bring that shortage to 130,000 by 2025. However, it appears that less than half of the states will be expanding Medicaid which will have a lessening impact on the shortage.
- It is believed that better reimbursements will be given to doctors with hospitals than those that are independent, possibly hastening the move to employed positions.
- All reimbursements are expected to decrease with specialists seeing a larger decrease than primary care doctors.
- In 1997 the number of residency slots was capped at 85,000. With the coming shortage projected and without an increase in new doctors…
- Doctors patient loads will continue to increase.
- Break-even point for financials will increase.
- More and more mid-levels will be taking the roles that doctors usually fill.
- Patient frustration may increase with longer wait times, not be able to see an actual doctor, and the possibility that some doctors may refuse Medicaid payment.
A significant caveat in the impact on individual states occurred when the Supreme Court struck down the provision that required states to expand Medicaid. As of now, approximately 20 states and DC look to expand Medicaid coverage. Without the expansion the overall benefit to hospitals and the challenge to doctors would be lessened.
Impact on Physician Recruiting
Already a tough search, primary care is going to get much tougher. Less desirable areas based on location, job duties, pay, etc. will see significant challenges. As metro areas see a greater need for doctors and are mostly more attractive because of the nearness of amenities, rural areas may see even more shortages. These shortages will become more dramatic in 2014 as provisions in the ACA require individuals to have coverage. The ten years following implementation of the ACA the problem could become exponentially more challenging unless solutions are found.
Possible outcomes could be that more and more clients come to recruiters to find these doctors with an added challenge to find a diminishing resource. In addition, we may see more metro clients who are going to be seeing shortages, especially in the Medicaid expanded states. Health care providers need to be aware of the Tsunami-like wave that is about to overtake primary care. Wise clients will be aggressive and make preemptive moves to address long term needs.
- Broadening the net to find candidates is step one – email campaigns, mailers, and all available resources need to be wisely considered. Saving money now may cost more, tremendously more in the future when the doctors are even more difficult to find.
- Clinics and hospitals should also consider widening their parameters.
- Compensation and benefits should be aggressive to lure and keep good candidates.
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by Joey Herald, Search Consultant at Fidelis Partners
Email: jherald@fidelismp.com
Phone: 949-441-1430
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