Case Study: Hospital Buys Doctor Practice...Patient Care Changes
By: Eric Bricker, MD
From 2019 through 2021, hospital systems acquired 4,800 physician practices. The story of Tryon Medical Partners’ acquisition by a major hospital system shows us how practices can change when they are bought by a hospital.
Specifically, 88 doctors, mostly primary care doctors, of Tryon Medical Partners left the hospital system in 2018, which had previously acquired them, to become independent.
Some of their grievances against the hospital system were:
- The hospital replaced the nurses in their clinics with medical assistants
- The hospital increased the number of patients they needed to see per day and decreased their visit times
- The hospital increased the size of their non-compete agreement from 15 miles to 30
Notice the impact on patient care… visit times were shortened. The doctors knew this change was not good for treating chronic conditions and keeping patients healthy.
Just one year later, Tryon Medical Partners began to participate in innovative ways to care for patients. The group began to take capitated payments for Medicare Advantage patients and take on risk for their care and their health.
For patients on employer-sponsored plans, Tryon began to offer Direct Primary Care to local employers and have since signed up 30 companies—some of which have thousands of plan members.
Tryon still has traditional Medicare patients and patients with commercial health insurance coverage through their employers. By being independent, Tryon can care for its patients the way their doctors think is best.
The move to independence by Tryon has been a huge success because an independent primary care practice can work to provide better care at lower costs.
Conversely, physicians associated with a hospital system are incentivized to see as many patients as possible, which leads to more referrals to specialists and increased healthcare costs.
Employers benefit from understanding that not all primary care is created equal and that independent primary care—that allows doctors to spend more time with patients—is key to employee health and controlling costs.
Employers can incentivize plan members to see high quality primary care physicians through Coupe Health. Coupe offers $0 deductible copay plans that have lower copays for higher quality doctors.
Financial alignment among plan members, employers and high-quality doctors can be achieved. In fact, we should expect no less.