Study finds new evidence of rapid physician practice consolidation

Continuing a decades-long trend, large numbers of physicians, particularly in primary care, migrated from smaller to larger groups from 2013 to 2015, according to a study from Leavitt Partners published in the September issue of Health Affairs.

Using data from Medicare's Physician Compare data set, researchers David Muhlestein, PhD, and Nathan Smith, PhD, found physicians in practices of nine or fewer dropped from 40.1 percent to 35.3 percent from 2013 to 2015. During the same period, physicians in practices of 100 or more increased from 29.6 percent to 35.1 percent, according to the analysis.

Drs. Muhlestein and Smith noted this migration from small to large practices was more common among primary care physicians than specialists. The percentage of PCPs in the smallest practices fell from 24.8 percent to 19.1 percent during the study period, compared to the percentage of specialists in the smallest practices, which fell from 21.0 percent to 19.9 percent.

The authors highlight three factors they believe spurred this consolidation: financial and technical challenges, an uptick in population-based contracts and generational preferences of young physicians who prefer larger practices. They also call for future research on the impact this consolidation could have on health outcomes and costs.


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