The pandemic accelerated a trend that’s been happening at Sanford over the past four years: More care is moving outside of the hospital, assuming it can be done safely and for less money elsewhere. One example of that is home oxygen monitoring.
When Sanford providers diagnose patients with COVID-19 but they’re not sick enough to require hospitalization, the patients take home an oxygen monitor with a sensor that allows providers to track their oxygen levels 24/7, Garcia said.
That program has worked out so well that Sanford is now exploring using it with its congestive heart failure or chronic obstructive pulmonary disease patients.
“Those people in the hospital that weren’t quite as sick, they won’t need to be here anymore,” Garcia said.
Modern Healthcare’s survey results also highlighted a widely predicted trend: the pandemic leading to more consolidation.
Almost 67% of health systems that responded to the survey said they plan to employ more physicians next year. About 31% said they don’t plan to change the number of employed physicians, and just 2% said they will employ fewer physicians next year.
The 50 health systems that responded to the survey employed almost 65,000 physicians collectively, or an average of 1,300 physicians each, at the end of fiscal 2019, which was about the same as in the prior year.
Private physician groups reported in-person visits dropped up to 60% in March, a decline that was only partially offset by virtual visits. For some, going it alone will no longer be an option. The CEO of North Carolina’s largest multispecialty physician group said in May he might eventually need to sell the practice to the local hospital.
RWJBarnabas Health employed about 1,000 physicians in its medical group at the end of 2019, up 8% from the prior year, and plans to hire even more next year. The West Orange, N.J.-based health system is working to fill service gaps, especially in specialties like endocrinology and rheumatology, said Dr. Andy Anderson, CEO of RWJBarnabas Health Medical Group.
The system is also looking to hire more primary-care providers.
Anderson said RWJBarnabas prefers to hire physicians over launching joint ventures and other arrangements because it can then align quality metrics with compensation, giving physicians incentives to improve their performance. It also enables better patient care coordination, especially once RWJBarnabas transitions to using a single electronic health record systemwide.
RWJBarnabas was among the majority of systems—68%—that said hiring more physicians last year did not materially affect financial performance. While physician practices themselves don’t tend to make money in the current healthcare reimbursement model, they do draw screenings, imaging, testing and surgeries to be performed in hospitals Anderson said.
Sanford also plans to hire more physicians next year, although Garcia said the health system is always in recruitment mode, especially for medical and surgical specialties. Once doctors start working at Sanford, they tend to stay, officials there say, but it’s difficult to attract them to the mostly rural areas of Minnesota, North Dakota and South Dakota that the health system serves.
Sanford budgeted to add a significant number of doctors this year, and Garcia said leadership made a conscious decision to enhance recruitment during the pandemic, not pull back.
“For us it’s an opportunity,” he said. “While others are firing people, while others are closing practices, while others are stopping recruitment, we actually did the opposite.”
Throughout the pandemic, Garcia said Sanford has not furloughed or laid off any of its employees, and even gave bonuses to hourly workers.
“We wanted to send a message that you’re part of a family,” he said. “We take care of you.”
SURVEY: Hospital Systems: 2020