Why are Physicians Prone to Merging their Practices?

Challenges of Running Solo Practice

If you are a solo healthcare provider or own a small medical practice, you might sometime feel the pressure of having to do everything on your own and struggling to provide optimal patient care. Running a healthcare practice offers unique challenges like administrative and insurance tasks, government and insurance regulations, technological updates, and staffing problems. It might lead to feeling why you decided to take this approach of practicing medicine in the first place.

That is when the idea of merging the practices comes into your head. You think of all the positives associated with this possibility, and don’t really dwell on the potential negatives. All you can envision is having someone else take care of all those daily responsibilities so you can get back to the job you really love i.e. patient care. If the thought of merging with a hospital or another medical practice did enter your mind, you are not alone either. The stats also suggest the same, in the second quarter of 2018, PricewaterhouseCoopers found that there were 255 healthcare merger and acquisition deals – the fifteenth consecutive quarter containing over 200 mergers. The prime reason for the continuing surge in acquisitions is that medical practices, especially the smaller ones, find it increasingly difficult to remain independent. Increased reporting burdens and financial challenges add to an already heavy stress load.

Reasons Why Physicians are Prone to Merging their Practices

In some cases, merging their practices works out well for the participants, while in others it turns into a disaster. If approached without an in-depth consideration of the pros and cons, a merger can create a host of new headaches and may even lead to patient and financial losses. When carefully considered, however, a merger between equal partners who can share resources and responsibilities can stand the test of time, increase patient satisfaction, and result in increased personal revenue for the medical provider. Some of the prime reasons why physicians are prone to merging their practices are listed below:

Better Compliance

With the government’s push towards a value-based healthcare system, compliance has increased to a great extent. The Centers for Medicare and Medicaid Services (CMS) have already implemented the concept of Clinical Quality Measures or CQMs for various initiatives in order to improve care quality, provide medical practices with reimbursement for reporting, and increase the amount of public information available. The Promoting Interoperability (PI) Program includes a performance-based methodology that focuses on a smaller set of objectives. The Quality Payment Program rewards value and outcomes through the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs). Practices that comply with these requirements realize maximum reimbursement, while those which are not in compliance do not achieve these levels. Merging with another practice or with larger healthcare organizations and pooling compliance systems increases the likelihood of being able to achieve top reimbursement levels.

Administrative Benefits

As a solo provider or small practice owner, you have to bear all the administrative burden on your own. You have to bear mortgage or rental payments for your office. You can’t negotiate volume discounts for office supply purchases. You might be a little hesitant to invest in new equipment and reluctant in attracting the most experienced personnel. When you merge with another practice, it brings buying power to the table and you can purchase much lower per unit costs as you are buying higher quantities of any given item. These cost savings leave more funds available for equipment, upgrades, and compensation packages. Variable and fixed overheads are now justified as you are sharing resources.

Focus on Patient Care

In solo practice, you might be handling everything on your own. Whether it’s managing building maintenance or ensuring insurance payments for all delivered services. As a healthcare provider, you are trained in delivering excellent patient care. Some providers might not have the necessary skills to manage administrative tasks, so they end up performing them poorly or paying other people to take care of them. A merger opens the practice up to more expertise, the acquiring partner might already have a building manager, expert billing team, and human resources department. When such administrative tasks are handled efficiently providers can focus more on patient care. Spending more time with patients will not only increases the quality of care but also opens the possibility for additional income because of the increase in patients seen.

Medical Billers and Coders (MBC) is a leading medical billing company providing complete revenue cycle services. We shared our observation on ‘why are physicians prone to merging their practices based on our experience of working with various providers and healthcare organizations. As a leading medical billing company, we can take away your burden of medical billing. We can help you to receive accurate insurance reimbursement for delivered services. To know more about our medical billing and coding services, email us at: info@medicalbillersandcoders.com or call us: 888-357-3226.