2016 Physician Inpatient/ Outpatient Revenue Survey A survey showing net annual inpatient and outpatient revenue generated by physicians in various specialties on behalf of their affiliated hospitals A resource from the nation’s leading physician search and consulting firm. ©2016 Merritt Hawkins 8440 Cypress Waters Blvd., #300 Coppell, Texas 75019 merritthawkins.com (800) 876-0500 2016 Physician Inpatient/ Outpatient Revenue Survey A survey showing net annual inpatient and outpatient revenue generated by physicians in various specialties on behalf of their affiliated hospitals 2 Introduction 3 Methodology 4 Survey Findings 6 Cost-Benefit Analysis 11 Trends and Observations 12 Conclusion 17 For additional information about this survey contact: 8440 Cypress Waters Blvd., #300 Phillip Miller Coppell, Texas 75019 (800) 876-0500 merritthawkins.com phil.miller@amnhealthcare.com (800) 876-0500 2016 Physician Inpatient/Outpatient Revenue Survey Introduction Merritt Hawkins is a national physician search and consulting firm specializing in the recruitment of physicians in all medical specialties, physician executives, medical academic leaders, physician assistants, nurse practitioners and other healthcare professionals. Established in 1987, Merritt Hawkins is a company of AMN Healthcare (NYSE: AHS), the largest healthcare workforce solutions organization in the United States as ranked by Staffing Industry Analysts. A Quantitative Analysis The survey is intended to provide benchmark data hospitals can use to develop a “quantitative analysis” of their physician recruiting programs. A quantitative analysis as defined by the U.S. Internal Revenue Service (IRS) establishes the financial benefits that newly recruited physicians may bring to a hospital. These benefits may support the hospital’s mission of providing quality care to the community by creating Merritt Hawkins conducts an ongoing series of surveys revenue streams necessary to its continued or its covering a range of physician staffing issues, including enhanced operation. A quantitative analysis therefore physician recruiting incentives, physician practice may serve as part of a hospital’s physician recruiting patterns, hospital recruiting patterns and related topics. plan by demonstrating the financial benefits to the Merritt Hawkins conducts surveys for both internal use hospital of physician recruitment. It should be noted, and on behalf of third parties. Third parties for which however, that a physician recruiting plan also should Merritt Hawkins has conducted surveys and other include a “qualitative analysis” demonstrating how research projects include The Physicians Foundation, newly recruited physicians will enhance quality of care the Indian Health Service, the American Academy in the community by adding needed services. of Physician Assistants, Trinity University, the Association of Academic Surgical Administrators, Cost/Benefit Analysis and the North Texas Regional Extension Center. Survey data also may be used in setting physician This report summarizes Merritt Hawkins’ sixth survey compensation levels or recruiting incentives through of the average annual revenue physicians in various a cost/benefit analysis comparing the aggregate specialties generate for their affiliated hospitals. This expense of recruiting physicians to the average revenue periodic survey was conducted previously by Merritt generated by physicians in various specialties. Results Hawkins in 2002, 2004, 2007, 2010, and 2013. of the survey also may be of interest to physicians, policy makers, journalists and others who follow physician staffing, compensation, and related trends. 2016 Physician Inpatient/Outpatient Revenue Survey 3 Methodology Merritt Hawkins emailed the Physician Inpatient/ Outpatient Revenue Survey to approximately 3,500 hospital Chief Financial Officers (CFOs) nationwide using a proprietary list of names that are included in its database of clinicians and healthcare administrators. The survey was emailed to all names on the list three times starting in December, 2015 and running through March, 2016, and additional surveys were emailed at approximately the same time directly to individual hospital CFOs by Merritt Hawkins’ research personnel. The survey could be taken anonymously or those CFOs requesting survey results could include their email addresses. The survey asked hospital CFOs to indicate the combined net inpatient and outpatient revenue generated annually for their facilities by a single, full-time equivalent (FTE) physician (either employed by the hospital or in independent practice) in a variety of specialties through procedures performed at the hospital, tests and treatments ordered, etc. In the case of primary care physicians (defined as family practitioners, general internists, and pediatricians), survey respondents were asked to determine revenue from direct admissions, 4 2016 Physician Inpatient/Outpatient Revenue Survey procedures performed, lab tests generated, etc., not indirect revenue primary care physicians may have generated from patient referrals to specialists utilizing the hospital. The survey listed various revenue ranges and allowed CFOs to select the most appropriate range for each medical specialty. In lieu of indicating a range, CFOs also had the option of indicating on the survey form the specific amount of revenue generated annually for their hospital per a single FTE physician in various specialties. In cases where a range was indicated, the survey takes the midpoint of this range to determine a weighted average for each specialty. A total of 74 completed surveys were received. physician specialties for their affiliated hospitals has remained virtually unchanged. In the six separate years Merritt Hawkins has conducted the survey (spanning an overall period of 14 years) that number has remained at or about $1.5 million. The only exception was in 2004, when the average annual revenue generated by all medical specialties tracked in the survey was $1.8 million. If the survey was not accurate due to a small data Accuracy Statement set or for other reasons, much larger variations in The survey was sent to each CFO on the mailing though there are variations in average annual list at least three times, and many received the revenue generated by specific specialties in given survey four or more times. Nevertheless, the years, the overall range for most specialties has repeated emails generated less than 100 responses, remained relatively narrow over the years. underlining the extreme difficulty of obtaining the type of physician revenue data sought by the survey. Hospital CFOs may find that retrieving the requested data can be difficult and some CFOs may be concerned about the proprietary nature of the data, though Merritt Hawkins does not track the data by hospital name or in any other way, ensuring the overall number could be expected. In addition, It should be noted that the volume of categorical responses varied by specialty. Not all returned survey forms included data for all specialties. Given these factors, average revenue generated per medical specialty cannot be expected to reflect the experiences of all hospitals. responses are kept completely confidential. Despite the relatively small data set, Merritt Hawkins believes survey results are reliable and accurate, in large part because the overall number for average annual revenue generated by all 2016 Physician Inpatient/Outpatient Revenue Survey 5 Survey Findings Responding Hospitals by Number of Beds Responding hospitals in 2016 by number of beds are indicated in the first chart below. The second chart shows a year-to-year comparison of hospital respondents by number of beds. It can be noted from the numbers below that survey responses by number of hospital beds closely reflect hospitals by bed size throughout the U.S. Responding Hospitals by Number of Beds 52% 23% 9% Hospitals by Bed Size in the United States* 16% 2016 51% 21% 12% 16% 100 or less 101-200 201-300 301 and above 2016 100 or less 101-200 201-300 301 and above *Source: The American Hospital Association Annual Survey of Hospitals, 2014 edition Responding Hospitals by Number of Beds (Year-to-Year Comparison) 70% 2016 2013 60% 2010 2007 50% 2004 2002 40% 30% 20% 10% 0% 6 100 or less 2016 Physician Inpatient/Outpatient Revenue Survey 101-200 201-300 301 and above Average Revenue Generated by Primary Care Physicians, Specialists, and All Physicians The first graph below indicates average annual net revenue generated by primary care physicians on behalf of their affiliated hospitals in the previous 12 months (a period generally corresponding to calendar year 2015) with comparisons to survey data from other years the survey was conducted. Primary care is defined in this survey as family practice, general internal medicine, and pediatrics. The second graph indicates average annual net revenue generated by specialist physicians on behalf of their affiliated hospitals, with comparisons to survey data from previous years. The third graph indicates net average annual revenue generated by all physician specialties tracked in the survey on behalf of their affiliated hospitals, with comparisons to data from previous years. Primary Care Physicians Specialist Physicians $1,402,268 $1,607,750 2016 2016 $1,566,165 $1,424,917 2013 2013 $1,385,775 $1,577,764 2010 2010 $1,433,532 $1,509,910 2007 2007 $1,596,852 $1,915,524 2004 2004 $1,272,862 $1,587,355 2002 2002 All Physicians $1,560,688 2016 $1,448,458 2013 $1,543,788 2010 $1,496,432 2007 $1,855,773 2004 $1,540,181 2002 2016 Physician Inpatient/Outpatient Revenue Survey 7 Specialty Revenue Comparison The following graphs indicate average net annual revenue generated by physicians in various specialties on behalf of their affiliated hospitals as tracked by the 2016 survey, with comparisons to data from surveys conducted in previous years. Cardiology (Non-Invasive) Cardiology (Invasive) $1,260,971 Family Practice $2,448,136 2016 2016 $1,493,518 2016 $1,232,142 $2,169,643 2013 2013 $2,067,567 2013 $1,319,658 $2,240,366 2010 2010 $2,240,786 2007 $2,662,600 2007 $1,615,828 2007 $2,646,039 2004 $1,662,832 2010 $2,490,748 2004 N/A $2,000,329 2004 $ 1,559,482 N/A 2002 2002 2002 Gastroenterology General Surgery Hematology/ Oncology $1,422,677 2016 $2,169,673 2016 $1,688,056 2016 $1,385,714 $1,860,566 2013 $1,761,029 2013 2013 $1,450,590 2010 $2,112,492 2010 $1,485,627 2010 $1,335,133 $1,947,934 2007 2007 $1,735,338 2004 $1,624,246 2007 $2,446,987 2004 $1,802,749 2004 $1,246,428 $1,835,470 $1,810,546 2002 2002 2002 Internal Medicine Nephrology Neurology $1,830,200 2016 $712,054 $1,025,536 2016 2016 $1,843,137 2013 $1,175,000 2013 $1,678,253 2010 $696,888 $1,987,253 $865,214 $2,100,124 $557,916 2007 $ 1,121,000 $ 924,798 2004 $1,569,000 8 2010 2007 2004 2002 $907,317 2010 2007 $691,406 2013 2004 $1,704,326 2002 2016 Physician Inpatient/Outpatient Revenue Survey $1,030,303 2002 Neurosurgery Obstetrics/ Gynecology $2,445,810 2016 Ophthalmology $1,583,209 $1,035,577 2016 2016 $1,684,523 $1,439,024 2013 $725,000 2013 $ 2,815,650 2010 2013 $1,364,131 $1,662,832 2010 $2,100,000 2010 $1,413,436 2007 $725,000 2007 2007 $2,406,275 2004 $1,903,919 2004 $842,711 2004 $2,364,864 $1,643,028 $584,310 2002 2002 2002 Orthopedic Surgery Otolaryngology Pediatrics $2,746,605 $1,066,221 2016 2016 $2,683,510 $825,757 $787,790 2013 2013 $2,117,764 2013 $856,154 N/A 2010 2010 $2,312,168 2010 N/A $697,516 2007 2007 $2,992,022 2007 $860,600 N/A 2004 2004 $1,855,944 $665,972 2016 2004 $690,104 N/A 2002 2002 2002 Psychiatry Pulmonology Urology $1,210,586 $1,190,870 2016 2016 $1,302,631 $1,009,868 $1,428,030 2013 2013 $1,290,104 $1,204,919 2007 $1,272,563 2007 $1,781,578 $1,332,948 2004 $1,382,704 2010 $1,332,534 $888,911 2007 2004 2002 $1,317,415 2004 $1,278,688 $1,138,059 2002 2013 2010 2010 $ 1,405,659 2016 $1,123,697 2002 2016 Physician Inpatient/Outpatient Revenue Survey 9 Specialty Comparison Year-to-Year The graph below shows average annual revenue generated per specialty for the four years the survey has been conducted. Cardiology (non-invasive) Cardiology (invasive) Family Practice Gastroenterology General Surgery Hematology/Oncology Internal Medicine Nephrology Neurology Neurological surgery Obstetrics/gynecology Ophthalmology Orthopedic surgery Otolaryngology Pediatrics Psychiatry 2016 2013 2010 2007 2004 2002 Pulmonology Urology $0 $500,000 $1,000,000 10 2016 Physician Inpatient/Outpatient Revenue Survey $1,500,000 $2,000,000 $2,500,000 $3,000,000 Cost/Benefit Analysis PHYSICIAN GENERATED REVENUE VS. AVERAGE SALARIES The following numbers compare the average net Specialty Average Revenue Average Salary* Cardiology (Invasive) $2,448,136 $525,000 Cardiology/Non-Inv. $1,260,971 $291,000 Family Practice $1,493,518 $198,000 Gastroenterology $1,422,677 $455,000 General Surgery $2,169,673 $339,000 the financial incentives offered to physicians in Hematology/Oncology $1,688,056 $350,000 the 3,128 physician search assignments Merritt Internal Medicine $1,830,200 $207,000 Nephrology $712,054 $275,000 Neurology $1,025,536 $277,000 Neurosurgery $2,445,810 $553,000 OB/GYN $1,583,209 $276,000 Ophthalmology $1,035,577 $249,000 Orthopedic Surgery $2,746,605 $497,000 Otolaryngology $1,066,221 $334,000 Pediatrics $665,972 $195,000 Psychiatry $1,210,586 $226,000 Pulmonology $1,190,870 $331,000 Urology $1,405,659 $412,000 annual inpatient/outpatient revenue generated by physicians in various specialties for their affiliated hospitals with average salaries or income guarantees offered to recruit physicians. Average salaries and income guarantee figures are derived from Merritt Hawkins’ 2015 Review of Physician and Advanced Practitioner Recruiting Incentives and indicate Hawkins conducted from April 1, 2014 to March 31, 2015. The numbers below may be used as part of a “quantitative” physician recruiting cost/benefit analysis showing costs of recruiting physicians relative to the revenue physicians generate for their affiliated hospitals. A “qualitative” analysis also will factor in the quality of care benefits that new physician services may bring to a given community. As these numbers indicate, physicians typically generate considerably more in “downstream revenue” than they receive in the form of salaries or income guarantees. This is particularly true of primary care physicians. Though hospitals and Source: Merritt Hawkins 2015 Review of Physician Recruiting Incentives * other employers have been shown to lose money on physician salaries is some cases, they often recoup these loses from the downstream revenue physicians generate. 2016 Physician Inpatient/Outpatient Revenue Survey 11 Trends and Observations Merritt Hawkins’ 2016 Physician Inpatient/ Outpatient Revenue Survey provides benchmark data indicating the estimated amount of net The average annual net revenue generated by inpatient and outpatient revenue physicians in specialty care physicians in the 2016 survey was 18 specialties generate annually on behalf of $1,607,750, up from $1,424,917 in 2013, an their affiliated hospitals through patient referrals, increase of 12.8%. In five of the six years Merritt admissions, procedures, treatments, and tests. Hawkins has conducted the survey, specialist The average annual net revenue generated by all 18 specialties examined in the 2016 survey was $1,560,688. This is an increase of 7.7% over average annual net revenue generated by all specialties as tracked in Merritt Hawkins’ 2013 survey and is consistent with survey findings in physicians as a group have generated more revenue for their affiliated hospitals than primary care physicians. The one exception was 2013, when primary care physicians generated $1,566,165 annually on average for their affiliated hospitals compared to $1,424,917 for specialists. others years when average net annual revenue In the six individual years Merritt Hawkins has generated by physicians for their affiliated hospitals conducted this survey (over a total period of 14 was approximately $1.4 million or $1.5 million. years), average annual revenue generated by all The one exception was 2004, when average net physician specialties has fluctuated from a low end annual revenue generated by all physicians for their of $1,448,458 in the 2013 survey to a high end affiliated hospitals was $1.8 million. $1,855,773 in the 2004 survey. However, for five The average annual net revenue generated by primary care physicians, defined as family physicians, general internal medicine physicians, and pediatricians in the 2016 survey was $1,402,268, down from $1,566,165 in 2013, a decrease of 10.5%, though in the same general range as previous years, with the exception of 2002, when average revenue generated by primary care physicians for their affiliated hospitals was $1,272,862. 12 2016 Physician Inpatient/Outpatient Revenue Survey of the six years, average annual revenue generated by all specialties has fluctuated by a much smaller margin, from a low end of $1,448,458 in the 2007 survey to a high end of $1,560,688 in the 2016 survey. For this reason, Merritt Hawkins is confident in asserting that the average net annual revenue generated by physicians in all specialties tracked for their affiliated hospitals has been and remains approximately one and a half million dollars. Additional Economic Impact of Physicians An additional point to be considered is that also exceeded $2 million in 2004. In the other four years, average annual revenue generated by family physicians was at or about $1.5 million. physicians have a direct economic impact not only Average annual revenue generated by pediatricians on the hospitals with which they are affiliated but also declined, from $787,790 in 2013 to $665,972 on the communities in which they practice. A in 2016, a drop of 18.3%. That is the lowest average report released by the American Medical Association for pediatricians recorded in the six physician revenue in 2014 indicates that physicians generate $1.6 surveys Merritt Hawkins has conducted, which trillion in economic activity nationwide and support reached a high of $860,600 in 2004. 10 million jobs. Each physician contributes $2.2 million in economic output and supports an Average annual revenue generated by general average of 13.84 jobs and an average of $1.1 internal medicine physicians as tracked in the million in wages and benefits. Every dollar applied 2016 survey ($1,830,200) was virtually unchanged to physician services supports an additional $1.62 compared to 2013, when the average was in other business activity (see Physicians Generate $1,843,137. In the six physician revenue surveys $1.6 Trillion in Economic Activity, Support 10 Million Merritt Hawkins has conducted, average net annual Jobs, www.assn.org/ama/pub/news/2014-04-16- revenue generated by general internists for their physicians-economic-impact, April 16, 2014. For affiliated hospitals has ranged from approximately additional information on physician economic issues $1.6 million to $2 million. see the Merritt Hawkins’ white paper, The Economic Impact of Physicians). Increases in revenue generated by family medicine and internal medicine physicians that were Shifts in Primary Care apparent in 2013 were attributed at that time to the growing employment of physicians by Net revenue generated by primary care physicians hospitals. In 2004, only 11% of Merritt Hawkins’ decreased in the 2016 survey relative to 2013, physician search assignments featured hospital the last year the survey was conducted. This was employment of the physician. In 2014, that particularly apparent in family practice, where average number rose to 64%, though it dropped to 51% revenue generated decreased from $2,067,567 in in 2015 (see graph on following page). the 2013 survey to $1,493,518 in 2013, a drop of 38.4%. 2013 represented the highest average Employed primary care physicians may be more likely to revenue generated by family practice physicians divert tests, therapies and other services “in-house” to in all six of the physician revenue surveys Merritt their hospital employer, rather than to outside resources Hawkins has conducted, though average annual such as radiology groups or labs, which may have been revenue generated by family physicians for hospitals their pattern when they were in independent practice. 2016 Physician Inpatient/Outpatient Revenue Survey 13 Such referral practices would help explain why average feature care for large population groups managed by revenue generated by primary care physicians for primary care doctors operating under a fixed or global hospitals is increasing. However, the 2016 survey did budget with a value-based reimbursement component. not reflect such increases, unlike the 2013 survey. If not a statistical aberration, declining revenues generated Under these models, high revenues generated by by family physicians tracked in 2016 (and flat revenues primary care and other physicians for their affiliated generated by general internists) relative to 2013 may hospitals could come to be seen as a negative, be a result of risk-bearing reimbursement models, completely turning on its head traditional healthcare where primary care physicians and their employers are economics in which high revenue generation has penalized for exceeding budgets. been seen as an economic imperative. Should these models proliferate, it can be expected that the Merritt Hawkins Search Assignments Featuring Hospital Employment of Physicians revenue numbers tracked in this survey will steadily decline as health systems and other large entities that employ physicians are rewarded for reducing 2015 51% services provided and thereby sharing in any savings 2014 64% realized from global or fixed budgets. 2013 64% 2012 63% 2011 56% The impact primary care physicians have on 2010 51% hospital revenue changes may be tied to the 2009 45% trend toward hospital employment of physicians 2008 45% in another way. The national survey of physicians 2007 43% 2006 23% 2005 19% 2004 11% Source: Merritt Hawkins 2015 Review of Physician Recruiting Incentives * Primary care physicians are particularly likely to be hospital and health system employees as many of these organizations have purchased primary care groups in order to participate in new delivery and reimbursement models such as Accountable Care Organizations (ACOs). These models increasingly 14 2016 Physician Inpatient/Outpatient Revenue Survey Differences in Productivity that Merritt Hawkins conducts biennially for The Physicians Foundation (www.physiciansfoundation. org) suggests that employed physicians may be less productive than physicians who are independent practice owners (see chart on next page). These numbers indicate that employed physicians see 8.5% fewer patients per day than do independent physicians. As the employed model becomes more established, revenue generated per primary care physician may plateau or begin to decline due to a drop in per-physician productivity. Patients Seen Per Day/ Employed Physicians vs. Independent the survey. The 2016 survey indicates that orthopedic surgeons generate an annual average of $2,746,405 on behalf of their affiliated hospitals, up slightly Employed Independent 20 21.7 Patients seen per day Source: A Survey of America’s Physicians: Practice Patterns and Perspectives, Merritt Hawkins and The Physicians Foundation, September, 2014 Medical Specialists Remain Revenue Generators The 2016 survey suggests that emerging global/ value-based payments have yet to reduce the revenue generating power of physician specialists. In many cases, capitated/value-based payment models remain aspirational and fee-for-service reimbursement remains the prevailing paradigm. A paper published in the March, 2016 edition of Health Affairs indicates that 95.7% of physician office visits in 2013 resulted in fee-for-service payments while only 5.3% were capitated payments. Volume, whether in the form of relative value units (RVUs) or traditional metrics such as net revenues or patients seen, remains the name of the game. The “$2 Million Club” Three types of specialists -- orthopedic surgeons, neurological surgeons and general surgeons -- all generate in excess of $2 million net a year on average for their affiliated hospitals, the 2016 survey indicates. As in previous years the survey was conducted, orthopedic surgeons remain the highest revenue generators among all medical specialties tracked in from $2,683,510 in 2013. In the six years the survey has been conducted, average net annual revenue generated by orthopedic surgeons for their affiliated hospitals has ranged from a low of $1,855,944 in 2002 to a high of $2,992,022 in 2004. The increasing sophistication and cost of replacement hips, knees and other devices used in orthopedic surgery helps ensure high revenue generation from this specialty. In addition, “certificate of need” (CON) restrictions have been put on physician-owned hospitals and ambulatory surgery centers, reducing or limiting venues where orthopedic surgery is performed outside of traditional hospitals. Patient demographics and the active lifestyle choices of the growing senior citizen population also are driving utilization of orthopedic surgery procedures. Second on this list is invasive cardiology, a specialty generating an annual net average of $2,448,136 in 2016, up from $2,169,643 in 2013. In each of the six years the survey has been conducted, the average net annual revenue generated by invasive cardiologists on behalf of their affiliated hospitals has never been less than $2.1 million. Other high revenue generating specialties include neurological surgery, a specialty generating $2,445,810 for affiliated hospitals in 2016, up from $1,684,523 in 2013. The relatively low 2013 number may have been a one-year aberration, as in the other five years the survey was conducted, the average number for neurological surgery exceeded $2 million. 2016 Physician Inpatient/Outpatient Revenue Survey 15 The 2016 survey indicates that the average annual affiliated hospitals is in part a reflection of patient revenue generated by general surgeons for their demographics. Patients 65 years old and older affiliated hospitals is $2,169,673, up from $1,860,655 generate a disproportionate number of physician in 2013. In the six years the survey has been visits and generate a disproportionate number conducted, average net annual revenue generated of medical procedures and tests. Though they by general surgeons on behalf of their affiliated represent only 14% of the population, patients 65 hospitals has ranged from a low of $1,860,655 in and over generate 37.4% of in-patient procedures 2013 to a high of $2,446,987 in 2004. and 47.1% of diagnostic tests (see graphs below). Other High Revenue Generators Though not part of the “$2 million club,” In-Patient Procedures by Age Group gastroenterologists, hematologists/oncologists, 29.2% 30.0% obstetrician/gynecologists, and urologists all generate an average of $1.4 million or more in net revenue on behalf of their affiliated hospitals, the 2016 survey indicates. Revenue generated by these physicians did not change appreciably in 2016 relative to 2013, and fluctuations in these under 15 15-44 45-64 psychiatrists, pulmonologists, and otolaryngologists for their affiliated hospitals all exceeded $1 million, the 2016 survey indicates. Nephrology, at $712,054, 65+ U.S. Population 65+ Number of Diagnostic Treatments/ Tests by Age 47.1% 33.1% survey has been conducted. cardiologists, neurologists, ophthalmologists, 14.0% 3.4% specialties have been moderate in the six years the Average annual revenue generated by non-invasive 37.0% 4.4% under 15 14.0% 15.5% 15-44 45-64 65+ U.S. Population 65+ Source: Center for Disease Control and Prevention is the only specialty tracked by the 2016 survey other than pediatrics, to generate less than $1 Older patients, who often have multiple organ million annually on behalf affiliated hospitals. systems or body parts that need treatment, require The Emerging Shortage of Medical Specialists As referenced above, the net revenue generated by various medical specialists on behalf of their 16 2016 Physician Inpatient/Outpatient Revenue Survey the care of physicians who specialize in treating these systems and body parts. These specialists include orthopedic surgeons, cardiologists, ophthalmologists, urologists, pulmonologists, psychiatrists, neurologists and other specialists included in this survey. With over 10,000 Baby are required to perform the complex surgeries, Boomers turning 65 every day, specialist physicians diagnostic tests, and other procedures and care that are likely to be in increasing demand. older patients often require. It is for this reason that the Association of American For this reason, and because payments for Medical Colleges (AAMC) projects a shortage of up procedures continue to be higher than those for to 90,400 physicians by 2025, the majority of them consultations, medical specialists are likely to (66,000) specialists. While advanced practitioners remain high revenue generators for their affiliated such as physician assistants and nurse practitioners hospitals, even with the advent of capitated and can supplement the physician workforce, specialists value-based delivery models. Conclusion Today’s healthcare system is in the midst of The data included in the survey may be of assistance to a transition in which volume of services is hospital executives preparing a “quantitative analysis” of predominantly valued and paid for, to one in which the impact of physician recruiting on their facilities. Such quality outcomes and other “value” metrics will be an analysis should be accompanied by a “qualitative valued and paid for. This transition also includes a analysis” documenting the impact on quality of care wave of hospital and medical group consolidations provided to the community of newly recruited physicians. and a landscape in which competition may be more between venues than between medical specialties. However, this transition is still in its initial stages. Data cited above indicate that volume-based, feefor-service models continue to be the predominate For additional information about this or other surveys conducted by Merritt Hawkins and other companies of AMN Healthcare, contact: paradigm, and volume of services continues to be largely driven by physicians. Little takes place in medicine that is not ordered by, reviewed by, or performed by a doctor. Merritt Hawkins’ 2016 Physician Inpatient/Outpatient Revenue Survey quantifies Phillip Miller the financial impact physicians have on hospitals as the Vice President of Communications initiators and providers of care – an average, per physician, (469) 524-1420 of $1,560,688 in net revenue generated per year. phil.miller@amnhealthcare.com 2016 Physician Inpatient/Outpatient Revenue Survey 17 Merritt Hawkins’ Additional Discussion Groups/ Surveys/White Papers Merritt Hawkins’ hosts a professional Discussion Group on LinkedIn to review and discuss matters pertaining to physician recruiting, compensation, workforce solutions and related healthcare trends. To join, visit http://linked.in/AB6mOC. Merritt Hawkins is an AMN Healthcare company. AMN Healthcare, the largest healthcare staffing organization in the United States, is the industry innovator of healthcare workforce solutions. Surveys and white papers completed by Merritt Hawkins or other AMN companies include: Topics include: · Survey of Physician Appointment Wait Times · A Survey of America’s Physicians: Practice Patterns and Perspectives (in partnership with The Physicians Foundation). · Review of Physician Advanced Practioner Recruiting Incentives · Physician Inpatient/Outpatient Revenue Survey · Survey of Final Year Medical Residents · White Paper: Incentive-Based Physician Compensation * White Paper: From Lodge Medicine to MIPS: Physician and Hospital Reimbursement” * White Paper: The Future of Medicine (published by “Health Affairs”) * White Paper: Ten Keys to Physician Retention * White Paper: The Cost of A Physician Vacancy * White Paper: RVU-Based Physician Compensation * White Paper: The Economic Impact of Physicians * Curriculum: Physician Recruiting, The University of Florida · Review of Temporary Healthcare Staffing Trends & Incentives · Review of Temporary Healthcare Staffing Trends & Incentives (Mid-level Providers) · Survey of Chief Nursing Officers · Survey Registered Nurses · Survey of Travel Nurses Books Written by Merritt Hawkins: · Will the Last Physician in America Please Turn Off the Lights? A Look at America’s Looming Physician Shortage, Fourth Edition · Merritt Hawkins Guide to Physician Recruiting · In Their Own Words: 12,000 Physicians Reveal Their Thoughts on Medical Practice in America (in partnership with The Physicians Foundation). For additional information about this survey or other information generated by Merritt Hawkins or AMN Healthcare, please contact: Merritt Hawkins / Corporate 8840 Cypress Waters Drive, Ste. 300 Coppell, Texas 75019 (800) 876-0500 Merritt Hawkins / Atlanta 7000 Central Parkway, NE, Ste. 850 Atlanta, GA 30328 (800) 306-1330 18 2016 Physician Inpatient/Outpatient Revenue Survey Merritt Hawkins / Irvine 19200 Von Karman Ave, Ste. 400 Irvine, CA 92612 (800) 288-1210 Speaking Presentations from Merritt Hawkins and AMN Healthcare An Educational Resource Merritt Hawkins and AMN Healthcare are committed to providing survey data and other information of use to healthcare executives, physicians, policy makers and members of the media. AMN Healthcare offers speakers to address healthcare industry trends in staffing, recruiting and finance. Topics include: · Doctors, Dollars and Health Reform · A History of Medical Practice in America · Clinical Workforce Solutions · Evolving Physician Staffing Models · Physician and Nurse Shortage Issues and Trends · How to Make Your Hospital or Group a Physician Magnet · New Strategies for Healthcare Staffing · Healthcare Reform and Workforce Issues · Economic Forecasting for Clinical Staffing · Allied Staffing Shortages · Vendor Management · Recruitment Process Outsourcing · Other topics Upon Request For more information or to schedule a speaking engagement, please contact: Phillip Miller Phil.Miller@amnhealthcare.com (800) 876-0500 8840 Cypress Waters Drive, Ste. 300 Coppell, Texas 75019 (800) 876-0500 toll free (469) 524-1400 local merritthawkins.com 2016 Physician Inpatient/Outpatient Revenue Survey 19 ©2016 Merritt Hawkins 8440 Cypress Waters Blvd., #300 Coppell, Texas 75019 merritthawkins.com (800) 876-0500