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3 Current Hospitalist Trends

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Hospitalists play an important role in patient care, treating acutely ill patients throughout their hospital stay. Demand for hospitalists is also in high demand: In 2012, hospitalists were the second-most placed specialty by The Medicus Firm.

The Society for Hospital Medicine estimates there are more than 40,000 practicing hospitalists in the country, up dramatically from about 1,000 practicing hospitalists in the mid-1990's.

Beyond rapid growth and increased demand for the specialty, some other trends are shaping hospital medicine as well. Here, Glenn Appelbaum, senior vice president of operations for North Hollywood, Calif.-based IPC The Hospitalist Company, shares three current hospitalist trends..

Consolidation

In the past few years, IPC has been continuing its strategy of acquiring smaller — and even some larger — hospitalist and post-acute groups. In the recent past, the company has acquired smaller hospitalist and post-acute physician practices in Alabama and Texas and three in Florida. Consolidation of hospitalist groups is a growing nationwide trend.

There are numerous drivers for this consolidation, according to Mr. Appelbaum. More frequently, small hospitalist groups are seeking larger partners to help them transition into healthcare's future landscape, which involves more capital and regulatory demands. Smaller groups are seeking partners to provide infrastructure, capital investments, training or recruitment help and help with the Physician Quality Reporting System, he says.

For small groups, these tasks can become "overly burdensome," Mr. Appelbaum says. "In the future, at least the smaller players are going to want to combine. I see that trend continuing."

Outsourcing

Small hospitalist groups are not the only ones turning to larger partners for help: Many hospitals are now considering outsourcing their hospitalist services to large hospitalist staffing groups to achieve quality gains and cost savings.

Instead of the hospital having its own employed group of hospitalists, it would turn to a larger practice that would staff a hospitalist program — like Boston-based Steward Health Care System did recently, and Barnabas Health in West Orange, N.J., has done for years.

Indeed, hospitals' outsourcing of clinical services is becoming more common, with hospitalist staffing falling in the top five most-outsourced patient care services, according to John Boland at Navigant.

Increased role in the care continuum

Despite their site-specific name, hospitalists are also beginning to play a larger role outside of the hospital, impacting the broader care continuum. Mr. Appelbaum says hospitalists are "facility-based," but that facility does not have to be a hospital — it can be a post-acute care facility or a long-term acute-care facility, for example.

Hospitalists' alignment with post-acute-care providers in the hospital's area can benefit patient care transitions. When a patient is discharged from the hospital, hospitalists can follow the patient and coordinate care with physicians in the post-acute-care facility to ultimately reduce readmission rates and increase patient satisfaction. Hospitalists are somewhat better equipped to facilitate these transitions since they are involved in the patients' care throughout their hospital stay.

As we move into the New Year, these three trends — hospitalist consolidation, increased outsourcing and spreading throughout the care continuum — will continue to evolve.

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