Bigger isn’t always better. This study about primary care physician practices proves it.

In primary care, like many other things, bigger isn’t always better. And in the case of primary care physician practices, this study backs it up.

It’s no secret among those who know me well that I have a strong affinity for small businesses and have long held that small and mid-size businesses are the backbone of our country’s economy. In an age of instant gratification where many flip businesses like houses, I find more often than not that it’s the small businesses and their leaders that champion the vision of building and sustaining meaningful companies committed to serving their clients while consistently providing jobs for themselves, their families and others in their communities. And, it’s the small businesses and their leaders that consistently prove to be the innovators.


The study is titled “Small Primary Care Physician Practices Have Low Rates of Preventable Hospital Admissions” and was recently published by The Commonwealth Fund.

This study supports my notion and could also be instructive to you, your family and even your employees when it comes to selecting a Primary Care Physician geared to the combination of the best care AND the best cost…

 “[T]he common assumption that bigger is better should not be accepted without question, at least in practices of 19 or fewer physicians,” the authors conclude. The authors also question the practice of insurers typically paying lower rates to physicians in smaller practices, which typically have no negotiating leverage. Such an approach may well be shortsighted, they say, since the lower preventable admission rates achieved by small practices compared with large groups can mean lower overall costs for patient care…”

Most Large Employers Are Keeping Coverage: Mandates, Rules and All

More on what large U.S. employers are choosing to do in the wake of added Obamacare mandates, rules and general confusion over what to do. A recent national survey shows one percent of employers have decided to stop providing health care this year while approximately five percent have decided they will exit the health care system completely. This information is from a survey of large employers conducted by Aon Hewitt, a large employee benefits consulting firm,

According to Jim Winkler, chief innovation officer for health and benefits at Aon Hewitt, “Employers remain committed to providing health benefits, but recognize the need for new approaches that fix those problems.”

The survey includes more than 1,230 employers who currently provide coverage to over 10 million employees and identifies that large employers intend to shift more costs to workers via a “house money / house rules” approach. About 40% of the employers who participated in the survey are shifting more responsibility on their workers by asking them to take a more active role in their health. This includes initiatives aimed at lowering costs and improving employee health by offering health screenings and more robust health care coverage along with lower premiums to those employees who maintain better health.

Another one third of the companies surveyed revealed their plans to move employees to a private health care exchange within three to five years. Employers who move to the private exchange approach plan to provide a subsidy or “credit” to each employee who will then take their “credit” to the exchange to purchase their own health care coverage. Employers will determine the amount they will provide as a subsidy and the amount will vary from employer to employer.

Aon Hewitt has developed it’s own exchange and claims more than 18 large employers with a combined 600,000 workers are already using it.

Winkler goes on to say that “Traditional cost management tactics do not address foundational issues in health care, including worsening population health and misaligned provider payment methodologies.”

This information is a summary of an article titled “Employers Keeping Coverage Despite Obamacare Mandates, Rules” that appeared recently on Forbes.com


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