Independently Owned Family Physician Practices Remain Critical Part of Primary Care
Independent physician-owned practices have cost and quality outcomes that are equal to, or better than, practices owned by systems, and the loss of independent practices could harm primary care access, quality, and costs. In a recent policy brief published in the Journal of the American Board of Family Medicine, One-Third of Family Physicians Remain in Independently Owned Practice, 2017-2019, authors Diane R. Rittenhouse, Andrew W. Bazemore, Zachary J. Morgan, and Lars E. Peterson, use a unique data source to update trends in independent physician-owned primary care practices by practice size (solo physician, 2-5 clinicians, 6-20 clinicians, > 20 physicians).
Entering pandemic “a third of family physicians in the U.S. still worked in independent physician-owned practices” notes Dr. Diane Rittenhouse, the study’s lead author. “That’s a substantial part of the primary care delivery system that should not go ignored. We need to better understand these practices and the value that they bring to patients.” Using data from the 2017-2019 American Board of Family Medicine (ABFM) Family Medicine Certification Examination Registration Questionnaire, the study only included family physicians providing continuity of care and calculated the proportion of family practices reporting that they worked in a practice that was independently owned. Over the three-year study period, the number of family physicians whose practice site was independently owned declined only slightly, from 34.2% to 32.1%.
Evidence shows that independent practices deliver care equal to or better than practices owned by hospitals and health systems. These independent practices face administrative burdens by not having access to the resources of larger health care systems. Longstanding physician payment policies disadvantage independent physician-owned primary care practices, contributing to closure and buyouts. Importantly, these data cover the years immediately prior to the COVID-19 pandemic, which has radically increased stress on independent practices due to a decrease in visit volumes, the need to access personal protective equipment, and access to telehealth solutions. Support for independent physician-owned primary care practices could still be established through payment reforms, accountable care organizations with a primary care focus, a primary care extension service, or a new national primary care service corp.
Read the policy brief here: https://www.jabfm.org/content/34/5/1033
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