For a five-doctor practice, the Advisory Board Co., a health-care research firm, projects the total first-year cost at between $126,000 and $346,500, including two added nurses.<\/p>\n
The upshot: Doctors fear a squeeze as they try to ramp up changes in tandem with evolving reimbursement schemes. “You’re asking a practice that may be only marginally viable as a business to invest in significant infrastructure,” says Glen Stream, president of the American Academy of Family Physicians. “Is the payment model going to be there to support that?”
Some doctors aren’t waiting to find out. Instead, they’re going to work for hospitals, which have greater financial resources and, because of their leverage with insurers, are also often paid more than small practices for the same services. The consulting firm Accenture projects that, by 2013, only around a third of doctors in all specialties will own their own practices, down from about 43% in 2009 and nearly half in 2005.<\/p>\n