Series editor(s): Dr. Leonard H. Friedman, Dr. Jim Goes, Professor Grant T. Savage
Subject Area: Health Care Management/Healthcare
|Title:||Horizontal and Vertical Integration of Physicians: A Tale of Two Tails|
|Author(s):||Lawton Robert Burns, Jeff C. Goldsmith, Aditi Sen|
|Volume:||15 Editor(s): Jim Goes, Grant T. Savage, Leonard Friedman ISBN: 978-1-78350-715-3 eISBN: 978-1-78350-716-0|
|Citation:||Lawton Robert Burns, Jeff C. Goldsmith, Aditi Sen (2013), Horizontal and Vertical Integration of Physicians: A Tale of Two Tails, in Jim Goes, Grant T. Savage, Leonard Friedman (ed.) Annual Review of Health Care Management: Revisiting the Evolution of Health Systems Organization (Advances in Health Care Management, Volume 15), Emerald Group Publishing Limited, pp.39-117|
|DOI:||10.1108/S1474-8231(2013)0000015009 (Permanent URL)|
|Publisher:||Emerald Group Publishing Limited|
|Article type:||Chapter Item|
Researchers recommend a reorganization of the medical profession into larger groups with a multispecialty mix. We analyze whether there is evidence for the superiority of these models and if this organizational transformation is underway.
We summarize the evidence on scale and scope economies in physician group practice, and then review the trends in physician group size and specialty mix to conduct survivorship tests of the most efficient models.
The distribution of physician groups exhibits two interesting tails. In the lower tail, a large percentage of physicians continue to practice in small, physician-owned practices. In the upper tail, there is a small but rapidly growing percentage of large groups that have been organized primarily by non-physician owners.
While our analysis includes no original data, it does collate all known surveys of physician practice characteristics and group practice formation to provide a consistent picture of physician organization.
Our review suggests that scale and scope economies in physician practice are limited. This may explain why most physicians have retained their small practices.
Larger, multispecialty groups have been primarily organized by non-physician owners in vertically integrated arrangements. There is little evidence supporting the efficiencies of such models and some concern they may pose anticompetitive threats.
This is the first comprehensive review of the scale and scope economies of physician practice in nearly two decades. The research results do not appear to have changed much; nor has much changed in physician practice organization.
Downloadable; Printable; Owned
HTML, PDF (1171kb)
Due to our platform migration, pay-per-view is temporarily unavailable.
To purchase this item please login or register.
Complete and print this form to request this document from your librarian