BLOG: Fighting Words
Keeping Solo Practice More Difficult for Doctors | Orlando Sentinel
Expert Advice on Getting Media Attention - Click Here to Listen | Podcast with Dr Marketing Tips| Orlando Sentinel
Marni Jameson Interview | Americas Web Radio
Great observations in Forbes by economist John Goodman, a friend of AID’s, and a fellow member of the National Physicians Council on Healthcare Policy.
Can The Government Make Doctors Better Doctors?
John C. Goodman, Forbes / Opinion CONTRIBUTOR
You can take this to the bank. Every innovation in the production of every good or service – anything that lowers costs or increases quality – originates on the supply side of the market. There has never been a successful innovation that originated on the demand side.
This principle applies to health care in spades. For as long as I have been in health policy – more than 30 years – I have been dealing with non-doctors who have a deep, abiding desire to tell doctors what to do. Yet I don’t know of any example anywhere in the world where this approach has ever worked.
If the definition of insanity is repeating the same thing over and over again and each time expecting a different result then “insanity” is the appropriate word here. The Obama administration has spent millions of dollars on pilot programs and demonstration projects in a fruitless attempt to discover how to better practice medicine. It has spent millions more trying to herd Medicare patients into Accountable Care Organizations – super HMOs with financial incentives to hit quality measures. That hasn’t worked either.
So what does the Obama Administration propose to do about all of this? More of the same. Read more here.
These hospitals make the most money off patients- and they're mostly nonprofits.
By Lena H. Sun May 3 at 10:41 AM
This post has been updated.
Seven of the top 10 most profitable hospitals in the United States are nonprofit facilities that each netted more than $150 million from caring for patients in 2013, according to a study published Monday.
Topping the list is Gunderson Lutheran Medical Center in La Crosse, Wis., which earned $302.5 million in profit from patient-care services that year, according to researchers from the Johns Hopkins Bloomberg School of Public Health and Washington and Lee University.
Other nonprofits in the top 10 include the Stanford Hospital in Palo Alto, Calif., which took in nearly $225 million, and the University of Pennsylvania’s hospital in Philadelphia, which earned $184.5 million.
“Most hospitals lose money, but there are a few very profitable ones and we need to pay attention to why they are making so much” and how it affects consumers, said lead author Gerard Anderson, a Hopkins health policy professor.
In study in Health Affairs, Anderson and co-author Ge Bai, an assistant accounting professor at Washington and Lee, analyzed only net income for patient-care services for fiscal 2013, the most recent year for which data were available. They didn’t include profits that hospitals earn from other activities, such as donations, investments, parking fees, rental space and sales from gift shops, which often are used to subsidize patient care.
“All hospitals should make a little profit,” Bai said, “but some hospitals are obtaining outrageous profits.”
In a statement, Gundersen said the report does not reflect its costs as an integrated health system in a largely rural, multistate region with a large Medicare population. It said the data used by the authors excluded some administrative and other costs that would have changed the medical center’s ranking. Read full article here.
To accommodate our growth and additional staff, AID recently moved its offices. We now have our own dedicated office space.
We all owe a huge thank you to AID co-founders Tom Thomas and Carol Zurcher (photo left) for providing space to AID in the Thomas, Zurcher & White, P.A., C.P.A. firm offices for the past three years. TZW also provided clerical and technical support as AID became established and viable. We certainly wouldn't be here without their generous support and vision.
Please note our new office address and phone number:
400 N. New York Ave, Suite 213
Winter Park, Florida 32789
Cancer costs soar 34% when hospitals own oncologists, Kaiser study shows. Read here.
Doctor-Hospital Mergers Fall 'Under Radar'
We think you'll appreciate this story recently ran in the New York Times that spotlights the troubling trend of "creeping consolidation." When hospitals buy up "a doctor here, and a doctor there," it adds up to higher patient costs and lower quality. We will be bringing this story and this issue to the attention of regulators at the FTC. Read more here.
This is exactly why the Certificate of Need requirement needs to be eliminated. We need another hospital and more competition.
Interested in joining the Association of Independent Doctors?
Click here to learn more about becoming a member.
By Marni Jameson
The start of a new year is a great time to take stock and ask whether you’re on the right course. For me, that includes reflecting on what has happened at the Association of Independent Doctors since I joined as executive director a little over a year ago.
What a difference a year makes.
Frankly, worthy though I thought the cause, I wasn’t sure the saving of America’s independent doctors was a fight we could win. But, fortunately, I relied on the opinions of two smart, forward thinking certified public accountants.
Tom Thomas and Carol Zurcher, both CPAs and partners at Thomas, Zurcher & White, an accounting firm in Winter Park, Fla., saw a need for a trade association dedicated to helping independent doctors survive. The worrisome trend of hospitals buying up medical practices was hurting the practice of medicine, driving up costs astronomically, and hurting communities financially.
But no one was speaking up for the doctors. So Thomas and Zurcher formed AID, and at the association’s charter meeting in April 2013, 100 doctors joined. Eighteen months later, when I came on board, AID had just shy of 300 members, and already a voice on the national stage.
Today, we are nearing 1,000 doctor members, in 14 states.
The reason behind AID’s exponential growth is simple. It’s the result of a timely message tied to a solution getting spread. When doctors ask me, “why should I join?” -- and lately they ask every day -- all I have to do is look back at the past year’s highlights, and share them.
Here are ten reasons:
1. Fast Growth: AID is the only national association dedicated to supporting independent doctors, and we are growing fast. In the past year, we have tripled our membership and now have nearly 1,000 doctor members in 14 states, coast to coast.
2. State Chapters: We have three chapters of AID outside of Florida, where we are based, and are looking to form chapters in every state. The existing chapters – Maine (260 members), California (61 members), and So. Carolina (36 members) -- were all groups of independent doctors that recognized they were simply running in place, and would be better off joining a national association and being part of a larger collective voice.
3. AID-SAVE: Thanks to a partnership we have established with McKesson and a national group purchasing organization, AID members save between 15% and 35% on medical on office supplies. The AID-SAVE program typically allows members to recoup the cost of membership -- $500 a year -- in fewer than three months.
4. Online Directory: If they choose, members may be part of AID’s online directory of independent doctors, which we will then promote to media, as part of a campaign telling consumers why it’s important to go to an independent doctor, and providing a tool for them to find one.
5. United Front: We give doctors the resources to champion their issues, and answer their questions, such as what to consider when asked to join a CIN, and whom to call for help with insurance contracting issues. We provide templates for letters to send to lawmakers, and materials for media outreach. This is only a sampling of the support membership provides.
6. Time and Expertise: The fight for independence takes time, money and knowhow. We have all three. In December we hired our second full-time person, a publicist with 18 years of public affairs and media experience. Together, along with the occasional intern, we work full-time getting the message out to consumers, media, businesses, and lawmakers about the importance of keeping doctors independent. Doctors are good at complaining, but not very good at organizing, communicating strategically and effecting change. We are.
7. Focus: We stick to our goals: Stop hospital-doctor consolidation, promote transparency in health-care pricing, push for parity in provider reimbursement by promoting site-neutral payments; help enforce anti-trust laws; and stop nonprofit hospitals’ abuse of their tax-exempt status.
8. Infrastructure: We were founded by business people, two CPAs and a health-care attorney. We are a 501c6 nonprofit, have all the proper insurances, dedicated office space and support staff, and are well capitalized.
9. Presence: In the past three months alone, AID has presented at the national MGMA conference in Nashville, on Capitol Hill at the National Physicians Council on Healthcare Policy, and at Becker’s Healthcare Forum in Chicago. The speaking calendar is filling for 2016. We are also a go-to source for national media, and have been cited in media dozens of times in the past year. We give independent doctors a collective voice that’s long been missing from the discussion.
10. We are stronger together.We will do an even better job as we grow. But to stop the trend of hospital consolidation, we need significant numbers, resources, and you.
Yes, we still have days where we feel like David up against ten Goliaths, the personification of our nation’s giant hospital systems and their lobby on steroids. But mostly days are marked by small steps toward progress, and the years marked by great strides.
For more information or to join AID, go to www.aid-us.org or call 407-865-4110.
Marni Jameson is the executive director of the Association of Independent Doctors. You may reach her at firstname.lastname@example.org.
An Open Letter From Independent Doctors
Educating patients about the importance of going to an independent doctor is key to keeping America’s health-care costs down. It is also essential to keeping our doctors independent. At the Association of Independent Doctors, we think a great place to start that education is right in the doctor’s office.
Hospitals spend hundreds of thousands of dollars each year marketing directly to patients, whom they then direct to employed doctors. To compete in this market, independent doctors need to tell consumers about the benefits of seeing a doctor who is not financially aligned with the hospital.
If you are an independent doctor, we encourage you to include a version of the following “Open Letter to Patients” in all your new patient packets, on your website, and in any correspondence you have with existing patients. Personalize it as you like, but do spread the word.
Congratulations on choosing an independent doctor for your care. Seeing an independent doctor – rather than a doctor employed by a hospital -- is one of the very best ways you can lower your medical costs and help your community.
When you see a doctor employed by a hospital, the hospital bills for that doctor’s services at hospital rates. Those rates are much higher than what independent doctors charge. Plus, the hospital tacks on what’s called a “facility fee,” a fee that adds absolutely no value, but that hospitals have negotiated to help cover their overhead. This can increase your cost by three to four times.
What’s more, hospital-employed doctors answer to administrators. Independent doctors remain free of those conflicts. In our practice, our focus remains on you.
The same holds true for centers that provide services like outpatient surgery or imaging (MRIs, CT Scans, X-rays, and mammography). Going to an independent surgery or imaging center will cost you less, sometimes one-fourth the price, of going to one owned by a hospital. This is why we do our best to refer you only to free-standing, independent facilities.
Many studies that have looked at the impact of hospitals acquiring independent doctors' practices and independent facilities have found that these mergers drive up health-care costs dramatically. Everyone pays. Patients pay more out of pocket. Workers pay higher premiums, and more of our taxpayer dollars have to go into programs like Medicare and Medicaid.
Finally, independent practices are small businesses that support their communities by providing jobs and paying taxes. When hospitals acquire these private practices, office workers lose jobs. If the acquiring hospital happens to be a nonprofit, the taxes the practice used to pay into the community go away, because nonprofit hospitals don’t pay taxes.
Most citizens know that nonprofit hospitals don’t pay income tax, but many don’t realize they are also exempt from property and sales taxes.
Unfortunately, figuring out which doctors or outpatient facilities are independently owned and which ones aren’t can be tricky. You have to ask. Often, when a hospital acquires a doctor’s practice, nothing else changes in the office – but your bill.
But rest assured, you’ve chosen wisely. Please make sure your loved ones do, too.
Your Independent Doctor
One way to help patients find an independent doctor near them is to direct them to AID’s online directory of more than 500 independent doctors in every specialty www.aid-us.org/directory. It’s a healthy choice.
McKesson and AID Partner to Form AID-SAVE
As independent doctors weather increasing cuts in their reimbursements, one way to help them survive is to help them cut their expenses. This is why members of the Association of Independent Doctors, a national nonprofit devoted to helping doctors stay independent, were excited to learn last month of a new money-saving program they could take advantage of through AID.
Working in partnership with McKesson, the nation’s leading supplier of medical supplies, pharmaceuticals, equipment, technology and services, AID-SAVE incorporates two supply-savings programs, and is available to AID members in all 50 states. Through the program, doctors can save – sometimes significantly -- on almost everything they buy for their practices, including medical supplies, office supplies, equipment and more.
Two-Part Program Adds up to Big Savings
SAVE on Everyday Medical Supplies
Part one of the AID-SAVE program lets members purchase more than two dozen common medical supplies at a discounted rate through McKesson.
To start saving, members simply contact their local McKesson account manager, who will confirm the member is a member in good standing. The account manager will then load pricing so the member can access savings. (If you don’t have a McKesson account manager, please contact Kent Olsen, at email@example.com (904) 624-9414 to find a representative in your local market.)
Group Purchasing Offers EVEN MORE Savings
Part two of the AID-SAVE program is a collaboration we formed with a group purchasing program that will yield even more savings on over 1.2 million items, including medical supplies, office supplies and equipment. The group purchasing program complements – and does not replace – the McKesson-brand program outlined above.
Though savings will vary among medical groups, most practices can expect to save between 15% and 35% on medical supplies alone through the AID-SAVE group purchasing plan. A test we ran for one large specialty group (and AID member) on one month’s worth of medical supplies found the group would save 19.2% under the new program.
In addition to saving on medical supplies, AID members may also benefit from saving programs available in the following categories:
Reference Laboratory (program varies by state)
AT&T, Verizon and Sprint Cellular Plans – for both the practice and the employees
US Pay – merchant processing
Imaging Capital Equipment and Contrast Media
More than 1,000 additional contracts are available to AID members!
“Most medical groups will recoup what they spend on their AID dues in one month,” said Don McGahee, who runs the group purchasing side of the program. “We believe in independent doctors, and want to do all we can to support them,” he said.
To benefit from these savings programs, you must be an AID member. For more information or to join, go to www.aid-us.org or call 407-865-4110.
Marni Jameson is the executive director of the Association of Independent Doctors. You may reach her at firstname.lastname@example.org.
Address: 400 N. New York Ave., Suite 213 | Winter Park, FL 32789
The Association of Independent Doctors (AID) is a 501(c)(6) non-profit organization.