Doctors urge HHS to level the playing field for independent practices

Doctors urge HHS to level the playing field for independent practices March 19, 2018

Vertical and horizontal integration has impacted the ability of independent physicians to provide quality care to their patients. This was the message sent to the Department of Health and Human Services (HHS), from a group of doctors responding to a Request for Information (RFI) regarding Promoting Healthcare Choice and Competition Across the United States. In part, the RFI’s intent was to seek “input from stakeholders on identifying existing state and federal laws, regulations, guidance, requirements, and other policies that limit choice and competition across health care markets.”

The Physicians Advocacy Institute (PAI) submitted a letter to HHS urging them to consider the independent physician’s contributions as well as their challenges in providing quality healthcare in an age of increased vertical and horizontal integration. Large hospitals and other healthcare facilities are merging, creating even larger and more financially powerful entities. At the same time, many hospitals are acquiring independent physicians’ practices.

The theory behind these integrations and acquisitions is that they lower healthcare costs and improve care coordination. However, PAI questions that theory and instead recommends that HHS “focus on programs and policies that create opportunities for independent physician practices, including solo and small group practices, recognizing the significant contributions these practices make to the nation’s health care.”

The PAI also stated that it “strongly supports HHS’ effort to adopt policies that promote a health care system that provides high-quality care at affordable prices, promotes competition, ensures fair and transparent policies, and prevents excessive consolidation.” Encouraging the HHS to level the playing field for smaller, independent physician practices, the PAI encourages “the Department to take into consideration the differences between practice sizes and the value of each, and to account for those differences as it develops new policies.”

Emphasizing that independent physicians provide quality care to their patients and that the horizontal and vertical integrations quite often impact that level of care, the PAI urged HHS “to have policies that do not limit choice or access, and that support fair practices, bargaining power, and market conditions, so physicians and practices already in the market can continue to provide care to their patients, as well as enabling new entrants and competition into the market.”