Although the hospitals in the Greenville-Spartanburg, S.C., region are hiring doctors at a rapid pace, coordinated care remains a problem, according to a community report, Greenville & Spartanburg: Surging Hospital Employment of Physicians Poses Opportunities and Challenges, released by the Center for Studying Health System Change.
Physician hires accelerate in S.C. market
The region, which has a population of nearly 1 million residents, is one of 12 communities that the Robert Wood Johnson Foundation and the National Institute for Health Care Reform have been examining since 1996 as part of a community tracking study. For the report, researchers from the Center for Studying Health System Change in July 2010 interviewed 45 area healthcare leaders representing hospital systems, physician groups, insurers, employers and others. Although there are some smaller institutions, the region is dominated by the four-hospital Greenville Hospital System University Medical Center and its 701-bed Greenville Memorial Hospital, and two-hospital Spartanburg Regional Healthcare System, anchored by the 530-bed Spartanburg Regional Medical Center.
Providers are seeking primary-care doctors in particular, and one hospital executive was quoted anonymously as saying, "There is a mad grab to hire PCPs." The report noted that Greenville Hospital's faculty practice has increased its number of physicians to 550 from 160 in three years, and that Spartanburg Regional system has increased its physicians to 270 from 180 in three years.
"The stepped-up employment of primary-care physicians highlights hospitals' efforts to gain market share, feed referrals to employed specialists, capture admissions and position themselves for expected changes in payment methods away from fee-for-service reimbursement toward more global or bundled payment under healthcare reform," according to the report.
The report also described how both systems are training more doctors and have established or enhanced relationships with medical schools in an effort to better align physicians with their institutions. Despite this, care coordination "remains a challenge" in part because of a lack of interoperability between provider electronic health-record systems. Efforts are under way, however, to better coordinate care for Medicaid and uninsured patients through the medical-home model, with a goal of reducing emergency department visits.
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