The new year is upon us, and prognosticators in all industries are making bold predictions for 2016. We at Barton took a look at last year’s headlines as well as the trends we have seen with our clients to make five predictions for 2016. Have a look!
More Physicians Will Become Employees
Physicians who are hang a shingle and open their own independent practices are now the minority. According to a survey conducted by the Physicians Foundation, more than half of physicians (53 percent) are employees of a healthcare organization or group practice. That represents a 10 percent increase since 2012.
Physicians are moving towards an employment for a number of reasons. For one, increased regulatory burdens and decreased reimbursements are making it hard for many physicians to keep their practices in the black. Many have found that employment allows them to worry less about the administrative tasks of running a business and focus more on caring for their patients.
The next generation of physicians are also attracted to the employment model because it offers greater work-life balance. Many new doctors are willing to forgo the long hours of building a private practice in order to have more time with their families.
Healthcare systems are also finding employment a more attractive option. With employed physicians, systems can often negotiate more favorable payment rates with insurers and achieve greater integration of care. With movement towards pay-for-performance payment models, facilities can also ensure that employed physicians are participants in the organization’s quality improvement initiatives.
NPs and PAs Will Play a Bigger Role in Primary Care
Fewer physicians are choosing to go into primary care at a time when demand for primary care services is increasing. To date, nearly 17 million Americans have gained healthcare insurance under the ACA. Since primary care is typically the first stop for insured people, demand, and the average wait time for an appointment, has shot up. The average wait for a primary care appointment is 18.5 days for major metropolitan areas.
The Association of American Medical Colleges estimates that the demand for primary care physicians will outpace the supply, leading to a shortage of 61,700–94,700 physicians by 2025.
Fortunately, the primary care NP and PA workforces are projected to grow far more rapidly than the physician supply. According to the HRSA, increased use of NPs and PAs in the primary care space could reduce the shortage to just 6,400 primary care physicians.
Studies show that NPs and PAs can manage 80–90 percent of care provided by primary care physicians. NPs and PAs have also been shown to expand access to primary care in urban and rural communities, where the need is greatest. In addition, research shows that primary care outcomes are comparable between patients served by NPs and patients served by physicians. Studies also show that patients are equally satisfied with medical care provided by both PAs and doctors and do not distinguish between types of care providers.
Mental Health Providers Will Struggle to Meet Demand
Here at Barton Associates, psychiatry is consistently one of our most requested medical specialties, and when you look at the numbers, it’s pretty clear why.
The U.S. has approximately 46,000 psychiatrists, but only 29,681 are actively practicing. And that number is likely to fall in the coming years.
A recent survey by the Association of American Medical Colleges found that 59 percent of psychiatrists are 55 or older, and the number of new psychiatric graduates has fallen from a high of 1,142 in 2000 to a low of 985 in 2008. Furthermore psychiatry residencies are increasingly being filled by foreign medical graduates; more than any other specialty.
This comes at a time when demand of mental health care is growing. The Affordable Care Act provides one of the largest expansions of mental health and substance use disorder coverage in a generation, requiring that health insurance plans, including all plans offered through the Health Insurance Marketplace cover mental health and substance use disorder services.
To close the gap, states and healthcare organizations are exploring other options. Some states have considered allowing psychologists, therapists who do not have a medical degree, to prescribe psychiatric medications to patients. It’s a move that psychiatrists oppose and has been rejected in several states.
In states that have favorable NP scope of practice laws, healthcare organizations are increasingly using psychiatric NPs to treat mental health patients. As more states expand these laws, this trend is likely to continue.
Finally, telemedicine is becoming a more attractive option. Psychiatrists and psychiatric nurse practitioners generally do not psychically examine their patients, which means visits translate well to video conferencing.The startup cost for implementing telepsychiatry in a facility is also much more affordable than staffing a full time equivalent.
Telemedicine Use Will Become More Common
A recent report from HIMSS Analytics’, the 2015 Telemedicine Study, found a three percent increase in the number of organizations using telemedicine solutions/services since 2014. The study found two-way video/webcam to be the most utilized telemedicine product/solution, with 70 percent of respondents reporting using that method.
Although the growth seems quite modest, it shows that organizations believe telemedicine can improve patient access to care.
Telemedicine remains in the early stages of adoption, and there are a number of barriersthat prevent healthcare providers and organizations from using the technology, including lack of training in the use of telehealth, insufficient standards of care, inadequate reimbursement for services, and unclear licensing requirements. As these barriers begin to come down, telemedicine growth will continue.
At Barton Associates, we too have seen more healthcare organizations express interest in telemedicine. In Spring 2014, we launched Barton Telehealth, a HIPAA-secure video conferencing platform, to provide our clients’ with a telemedicine coverage option. The demand is greatest for mental health services, mostly because there is a need and treatment does not require direct contact with the patient. However, the technology also lends itself to other specialties such as, primary care, family medicine, urgent care, and dermatology.
The Locum Tenens Market Will Grow
Staffing Industry Analysts predicts that the locum tenens market will grow 6 percent in 2016, with significant growth in the nurse practitioner and PA markets. Seeing that demand for NPs and PAs on the rise overall, it makes sense that growth will translate to the locum tenens market as well. Here at Barton Associates, we have seen a steady increase in NP and PA placements each quarter since we began placing advanced practice providers.
Staffing Industry Analysts attributes much of the growth in the locum tenens market to the employment trend. Employed physicians, NPs, and PAs receive mandatory vacation time, which creates coverage gaps for hospitals. And coverage gaps mean opportunities for locum tenens coverage solutions.
Moreover, the growing physician shortage and increase in demand for healthcare services will create even more coverage opportunities for locum tenens providers to fill.
What Are Your Predictions?
Now that you’ve read our predictions, what do you think? Tell us in the comments.