Hepatitis B Vaccine: Is It Safer Than Hepatitis B?

I am in Washington DC this week meeting with Members of Congress. One of my topics will be consolidation and site neutral payments. This week I spoke with a friend of mine who is looking at options for their neurosurgery practice. The hospital system sent this email in response to finding out the surgeon was considering independent practice. Our system is upside down. Doctors who take risk in running their practices are making more money by joining hospital owned practices. Why? Because hospitals can use Hospital Outpatient Departments (HOPDs) that pay physicians through a different fee schedule (that is much higher than the physician fee schedule) and that HOPD schedule increases with inflation every year unlike physician fees. What does this mean? It means your physician is more likely than not employed by someone else which increases the cost of care. Congress needs to act to improve independent physician pay and ensure that the pay keeps up with inflation. The current fee system encourages massive consolidation and inflates the costs of care as a result We also need to ask why a hospital group would be encouraging physicians to not pursue independent practice. The doctor is going to use their hospital for cases whether they become employed or not, which is how the hospital should make money. The reality is that this model of HOPD physician employment means hospitals can earn additional money by employing physicians and also typically put significant noncompete language in the contract preventing the doctor from using competitors. This needs to stop and these types of letters are egregious, self-serving, and hurt Americans. Let’s let doctors be doctors and practice in the way they see fit!