The U.S. Congress passed the federal budget for the fiscal year (FY) 2019 on February 8, 2018, which will fund the government through September 2019. This budget will increase domestic spending by over $128 billion over the next two years, including areas dealing with healthcare. The most significant areas in the FY 2019 budget for medical practices include the following:
The “Millennial” generation, usually defined as those born between 1982 and 1997 (or 1980 through 1994, depending on who you ask) is currently the youngest age group to take its place in the working world, behind their “Gen-X” parents and older siblings, who in turn are right behind the aging Baby Boomers (which currently make up the majority of physicians in the process of retiring or already retired, hence the need for younger replacements.)
The passage of the Medicare Access and CHIP Re-authorization Act of 2015 (MACRA) was intended to replace fee-for-service (FFS) with a framework that rewards providers for better outcomes and improved quality of care of population health while containing per capita costs. This shift places more emphasis on the entire care community’s coordinated efforts in sharing in both risks as well as responsibilities of the costs and outcomes. Although the impact of the law is currently focused on Medicare, its framework and delivery incentives are increasingly becoming the new model for other payers – and in the process, turning the health care delivery and reimbursement systems on their heads.
Many small or solo independent practices would like to agree with the humorist Mark Twain, who once quipped that “the reports of my death are greatly exaggerated.” However, the truth is that independent practices are disappearing, with many being absorbed into larger hospital or other organizational networks. According to a survey by the Physicians Foundation, the number of physicians who were employees of hospitals or other medical groups increased from 44 percent to 53 percent in recent years.
Threats of ejection from payers’ networks, along with declines in reimbursement and adding the strain of keeping up with changing government regulations and incentive programs have caused many providers to wonder if it’s still possible to maintain an independent, profitable practice. While some may eventually turn to employment, for those wishing to stay independent it may be worth investigating joining an independent physician association (IPA) or similar entity.
You are ready to open your own medical practice. Unless you opt to work with an established group practice, there are a number of tasks that you’ll need to complete before you’re ready to open for business, such as developing a viable business plan, choosing a form of ownership, and getting a start-up loan.
Regardless of which form of ownership you ultimately decide upon, there are some things that must be done as soon as possible before you can start a new medical practice in Georgia. Like any other successful business – and you are a business, as well as a health care provider – you’ll need a plan, as well as the help of an attorney experienced in setting up medical practices. In addition (but not in place of) your legal adviser, if you are building a practice from the ground up rather than choosing an existing turnkey location you may want to consider hiring a certified professional medical practice consultant.
