PHYSICIANS: “Aging Out”

Posted on March 22, 2023 by Dr. Marcinko

By Staff Reporters

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According to HealthcareBrew, thousands of doctors are expected to reach retirement age in the next three years, and their replacements won’t be physicians. Instead, physician assistants (PAs) and nurse practitioners (NPs) will increasingly provide primary care services, according to a report from consulting firm Mercer.

By 2026, 21% of family medicine, pediatric, and obstetrics and gynecology physicians—or about 32,000 doctors—will be 65 or older, and Mercer anticipates about 23,000 physicians will leave the profession permanently. At the same time, demand for primary care physicians is expected to grow 4%, the report found.

PAs and NPs—also called advanced practice providers (APPs) or physician extenders—are highly trained medical professionals. To become a PA, you have to have both a bachelor’s and a master’s, some clinical work experience, pass the Physician Assistant National Certifying Exam, and then apply to get licensed in your state (you know, easy peasy). It takes seven to nine years to go through that process, compared to 11+ years to become an MD.

CITE: https://www.r2library.com/Resource/Title/0826102549

To become an NP, you must have both a bachelor’s and a master’s in nursing, become a registered nurse, and pass a national NP board certification exam. It takes between six to eight years to become an NP.

Compared to physicians, PAs and NPs are “considerably younger professions with less than half the retirement risk,” the Mercer report stated. Roughly 40,000 PAs and NPs join the workforce annually.

“We’re certainly going to see increasing demand for APPs,” David Mitchell, a partner in Mercer’s career consulting business and a specialist in the healthcare industry, told Healthcare Brew.

While most state licensing boards require a physician to oversee APPs, both PAs and NPs have the authority to do many services primary care physicians do, like seeing and diagnosing patients, ordering lab tests, and writing prescriptions, said Mitchell.

READ HERE: https://www.healthcare-brew.com/stories/2023/03/16/non-mds-will-provide-primary-care?cid=30859907.17846&mid=349b552221c994e2540a304649746d7c&utm_campaign=hcb&utm_medium=newsletter&utm_source=morning_brew

MORE: https://www.aamc.org/data-reports/data/2022-physician-specialty-data-report-executive-summary

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VENTURE CAPITAL FUNDING: Slowing Down in Health Care!

Posted on March 4, 2023 by Dr. Marcinko

By Staff Reporters

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Venture capital funding in the digital health space cooled significantly in 2022 following a red-hot 2021; according to Healthcare Brew. Overall, digital health companies raised $15.3 billion last year, down substantially from the $29.1 billion raised in 2021—but still above the $14.1 billion raised in 2020, according to research from Rock Health, a seed fund that supports digital health startups.

Analysts predict investors will still put a good amount of money into digital health in 2023, particularly in alternative care, drug development technology, and software that reduces physician workload. But investors will likely pull dollars away from a few specific sectors this year.

“There is definitely more diligence, a little bit more skepticism in the investments that are made. So you tend to see investments go slower because diligence is taking longer or investors are being a little bit more conservative,” Adriana Krasniansky, head of research at Rock Health, told Healthcare Brew.

Direct-to-consumer products. The first sector in which Krasniansky expects to see funding slow this year is direct-to-consumer (DTC) products. One reason is that with recession fears, “Consumer spend is not as readily available,” Krasniansky said.

But Apple’s new data privacy rules are also partially to blame. As of April 2021, apps sold through Apple’s App Store must ask users for permission to track activity, and users can opt out. That tracking data is crucial for advertisers to create personalized ads.

“Apple’s privacy measures have impacted customer acquisition costs, making the DTC channel more challenging for a lot of startups—and not just digital health startups,” said Krasniansky.

READ: https://www.healthcare-brew.com/stories/2023/02/21/digital-health-hesitancy?cid=30649741.22835&mid=349b552221c994e2540a304649746d7c&utm_campaign=hcb&utm_medium=newsletter&utm_source=morning_brew

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RECESSION: Healthcare Industry Layoffs

Posted on February 5, 2023 by Dr. Marcinko

Not even the healthcare industry is recession-proof

By Staff Reporters

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According to Kristine White of Healthcare Brew, New York City-based Memorial Sloan Kettering Cancer Center (MSK), one of the country’s top cancer treatment facilities, laid off 337 employees on Jan. 17 in response to ongoing financial challenges, according to a New York State Department of Labor filing.

The 337 employees, who worked across 14 sites and in multiple departments, represent about 1.5% of MSK’s 22,500 employees. This is a slight decrease from the expected 3% of layoffs announced in November 2022.

“This reduction was necessary to ensure that MSK can continue to invest in the future of cancer care, research, and education for the benefit of generations to come, and every effort has been made to ensure that patient care is not impacted,” spokesperson John Connolly said in a statement shared with Healthcare Brew.

The institution’s operating losses totaled $116.1 million for Q3 of 2022, compared to a loss of $8.7 million during the same period in 2021, according to a quarterly financial report released in November last year.

Factors such as increased patient activity, wages, and supply costs from inflation pushed the system’s operating expenses up by 7.5% from Q3 of 2021 to Q3 of 2022. The cancer center hired more staff in 2022 with the expectation that patient volume would increase, according to the financial report.

CITE: https://www.r2library.com/Resource/Title/0826102549

Health systems like MSK often reevaluate their biggest expense (workers) when business is down, Lori Kalic, a healthcare senior analyst at consulting firm RSM, told Healthcare Brew.

Just this year, multiple hospitals and health systems have also announced layoffs, including Tufts Medicine in Boston and Integris Health in Oklahoma, according to White.

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HOSPITALS: Financial Management Update

Posted on January 21, 2023 by Dr. Marcinko

By Staff Reporters

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ORDER: https://www.amazon.com/Financial-Management-Strategies-Healthcare-Organizations/dp/1466558733/ref=sr_1_3?ie=UTF8&qid=1380743521&sr=8-3&keywords=david+marcinko

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Hospitals saw a slight financial boost in November 2022, despite continued negative operating margins throughout the year, according to a new Kaufman Hall National Hospital Flash Report, as reported in Healthcare Brew.

Lower expenses and increased outpatient revenue help buoy their performance and increase margins by 12% month over month from October 2022. But Kaufman Hall, a management consulting firm, reported that its year-to-date operating margin index reflected an actual negative figure of -0.2% in November 2022.

The findings underscore the financial challenges hospitals continue to face as they recover from the Covid-19 pandemic.

And, Erik Swanson, senior vice president of data and analytics at Kaufman Hall, wrote that the “November data, while mildly improved compared to October, solidifies what has been a difficult year for hospitals amidst labor shortages, supply chain issues, and rising interest rates.”

ORDER: https://www.amazon.com/Hospitals-Healthcare-Organizations-Management-Operational/dp/1439879907/ref=sr_1_4?s=books&ie=UTF8&qid=1334193619&sr=1-4

The monthly report, which is based on data from more than 900 hospitals, partially attributed November’s lowered expenses to a decline in patient volume and slightly shorter lengths of stay. Decreased labor costs, likely due to a drop in a reliance on contract labor, also helped lower expenses, the Kaufman analysis found.

CITE: https://www.r2library.com/Resource/Title/0826102549

Hospitals further saw a 10% increase year over year in outpatient revenue in November 2022, despite inpatient revenue remaining flat, according to the report. Swanson said “[h]ospital leaders should continue to develop their outpatient care capabilities amid ongoing industry uncertainty and transformation.”

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HEALTHCARE FRAUD: Predatory Senior Medicare Scams

Posted on January 20, 2023 by Dr. Marcinko

By Staff Reporters

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As you likely know, the US spends much on healthcare ($4.3 trillion in 2021, to be exact). But did you also know that healthcare fraud makes up a not-so-small piece of that pie?

The National Health Care Anti-Fraud Association (NHCAA), a national organization that works to prevent health insurance fraud, conservatively estimates that 3% of the US’s total annual healthcare spend—a hearty $129 billion—is lost to healthcare fraud. Some government agencies estimate that percentage to be as high as 10% (that’s $430 billion), according to the NHCAA.

Overall, Medicare fraud costs the US about $60 billion each year, Nicole Liebau, national resource center director for Senior Medicare Patrol, a government-funded organization designed to help prevent Medicare fraud, told Healthcare Brew, though she added that “the exact figure is impossible to measure.”

CITE: https://www.r2library.com/Resource/Title/082610254

While Medicare fraud isn’t new, the US saw a rise in one particular tactic during the pandemic: a durable medical equipment (DME) scheme.

How the schemes work.

In a DME scheme, scammers target Medicare patients—often after a procedure or an injury—and cold-call them to offer free equipment, said Jennifer Stewart, senior associate general counsel and senior director of fraud prevention and investigation at Blue Cross Blue Shield of Massachusetts. The scammers offer consumers items like lidocaine, wheelchairs, walkers, or braces.

The scammers have roped in doctors—who are often unaware they’re working with scammers instead of legitimate medical companies—to sign off on prescriptions that are then used to bill Medicare for the equipment, Stewart said. Sometimes patients actually receive the products, and sometimes they don’t.

“It’s really dangerous because [a prescription like lidocaine] could have reactions with other medications. The durable medical equipment isn’t sized for them, and certainly the doctor who treated their injury didn’t prescribe it […] There is a lot of patient harm involved,” Stewart said. Keep reading here.

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