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Despite some tumult in the market, tailwinds that have propelled Medicare Advantage popularity persist in 2023. The competitive complexity and changes have far-reaching implications for health care services organizations whose businesses are built on serving this important segment.

5 questions primary care physicians should ask as Medicare Advantage enrollment continues to grow

Discover the strategies that are transforming healthcare practices.

 Learn how top practices are using innovative solutions to optimize patient engagement, reduce costs and increase revenue. Our comprehensive guide, 

"HealthTech Survey: What Specialty Practices are Using to Fuel Profitability,"

 reveals the latest trends and best practices in healthcare technology. 

 to gain valuable insights and unlock the potential of your practice.

Fill out the form below to download the guide:

Healthcare practices are increasingly adopting innovative strategies to enhance patient engagement, reduce operational costs, and boost revenue. A comprehensive guide provides insights into the latest trends and best practices in healthcare technology, offering valuable information for specialty practices aiming to improve profitability. By leveraging these technological advancements, practices can unlock their full potential and achieve significant improvements in efficiency and financial performance. The guide serves as a resource for understanding how top practices are successfully integrating these solutions into their operations.

Discover the strategies that are transforming healthcare practices. Learn how top practices are using innovative solutions to optimize patient engagement, reduce costs and increase revenue. Our comprehensive guide, "HealthTech Survey: What Specialty Practices are Using to Fuel Profitability," reveals the latest trends and best practices in healthcare technology. Download now to gain valuable insights and unlock the potential of your practice.

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HealthTech Survey: What Specialty Practices Use to Fuel Profitability 

 examined the prevailing trends in physician salaries, and private practices are the place to be if you want a better salary.

Private practices continue to offer the highest 

, with physicians witnessing an 8.4% median salary increase from $253,731 in 2022 to $275,072 in 2023. In contrast, hospitals present a mixed picture, showing an average increase of 3.3% but a decrease in median salaries from $252,011 in 2022 to $244,373 in 2023.

While overall, the average physician salary increased by 5.8% from 2022 to 2023, after adjusting for inflation, the buying power for the average doctor's salary rose by approximately 2.5%, surpassing the national average salary increase for all U.S. workers at 4.6%.

However, the recently passed 2024 Physician Fee Schedule introduces a 3.4% conversion factor reduction in Medicare payments, impacting the value of services billed for Medicare coverage. This cut, from $33.89 to $32.74 in the calendar year 2024, raises concerns among doctors, particularly as 36% of their existing patients use Medicare, and 66% of practices accept Medicare.

The survey also examined trends in physician negotiations and supplementary income sources. While 43% of doctors have successfully negotiated higher salaries, 41% have never attempted to negotiate. Additionally, 44% of physicians supplement their income with side work unrelated to their primary practice, with men being more likely to engage in side jobs than women.

 persist, with the median salary for male doctors in 2023 at $284,853 compared to $226,034 for female doctors. Despite a median salary increase of 8% for men, women experienced only a 2.9% increase.

According to the survey, 43% of doctors report that Blue Cross Blue Shield typically pays the most for services, followed by United Healthcare at 21%, and Aetna at 19%.

The survey was conducted in November 2023 among 300 physicians who had been in their current practice at least two years.

Private practices offer the highest physician salaries, with an 8.4% increase in 2023. Hospitals show a mixed trend, with a 3.3% average increase but a decrease in median salaries. Adjusted for inflation, physician salaries rose by 2.5%, outpacing the national average. The 2024 Physician Fee Schedule's 3.4% Medicare payment cut raises concerns, as many practices accept Medicare. Gender pay disparities persist, with male doctors earning significantly more than female doctors. Many physicians supplement income with side work, and Blue Cross Blue Shield is the top payer for services.

Survey shows that on average, physicians in private practice made more money than those working for hospitals

Topics

Want more pay? Work for a private practice

Question: Can you tell me the difference between an annual physical and an Annual Wellness Visit (AWV)?

 While both types of exams have prevention in mind, there are many differences between them.

An annual physical is a more extensive exam than a Medicare Annual Wellness Visit. A typical annual physical is a “hands-on” type of visit, including a physical exam and any blood work or lab tests that may be part of the exam or necessary for the patient’s chronic stable problems.

Alternatively, the AWV is a “hands-off” risk assessment.The purpose of the AWV is to identify gaps in care, improve the quality of care that a provider delivers, and help paint a picture of a patient’s current state of health to create a baseline for future care.

An annual physical exam is an assessment of your body’s health. The primary purpose is to look for health problems.

During the exam, your doctor uses his or her senses – mainly sight, touch and hearing – to gauge how your body is performing. Based on what’s learned, your doctor may ask you to have tests to discover or rule out possible health problems.

The list below shows some of the things a physician may do during a physical exam.

Visually check the patient’s body overall for signs of existing health issues:

Perform an exam of the patient’s eyes, ears, nose and throat for potential problems

Listen to the patient’s heart and lungs to detect irregular sounds

Measure height, weight and blood pressure

Submit or order urine and blood samples for lab testing, for screening purposes and for ongoing chronic conditions

As a rule, Medicare does not cover an annual physical. The exam and any tests your doctor orders are separate services, and you may have costs related to each depending on your Medicare plan.

What’s Included in a Medicare Wellness Visit?

A Medicare AWV, also called a wellness exam, is an assessment of the patient’s overall health and well-being. The primary purpose is prevention – either to develop or update the patient’s personalized prevention plan. Medicare covers an AWV once every 12 months (11 full months must have passed since your last visit), and patients are eligible for this benefit after they have had Part B for at least 12 months.

During the exam, a physician or APP (usually a primary care provider) combines information from the visit with the patient’s medical record to gauge your risk for common preventable health problems such as heart disease, cancer and type 2 diabetes. Based on what’s learned, your doctor creates your personal prevention plan with a checklist of screenings you need to have.

The list below shows what should be performed during a wellness exam.

Review your health risk assessment (questions you answer about your health)

Confirm patient’s medical and family history

Record current medications (including prescriptions and over the counter medications) and providers

Measure and document patient’s height, weight and blood pressure

Look for signs of memory loss, dementia, frailty, depression, stress, pain and fatigue

Review behavioral risks, including tobacco use, physical activity, nutrition, oral health, alcohol consumption, sexual health, motor vehicle (i.e., seat belt use), and home safety

Document patient’s health risk factors and treatment options, including referrals to education and counseling programs

Develop a screening schedule (like a checklist) for the preventive services recommended for you

Review potential risk factors for Opioid Use Disorder (OUD)

Screen for potential Substance Use Disorders (SUDs)

Advance Care Planning (e.g., living will, health care power of attorney), if patient chooses to

Medicare Part B covers an Annual Wellness Visit and many preventive screenings with no copay or deductible. However, you may have to pay a share of the cost for certain recommended tests or services.

Renee Dowling is a compliance auditor for Sansum Clinic, LLC, in Santa Barbara, California.

An annual physical is a comprehensive, hands-on examination focusing on identifying existing health issues through physical exams and lab tests. In contrast, the Medicare Annual Wellness Visit (AWV) is a hands-off risk assessment aimed at prevention, updating personalized prevention plans, and identifying care gaps. The AWV includes reviewing health risk assessments, medical history, and behavioral risks, and developing a screening schedule. Medicare covers the AWV and many preventive screenings without copay or deductible, while annual physicals are not typically covered under Medicare.

Can you tell the difference between an annual physical exam and an Annual Wellness Visit (AWV)?

Physical exam vs. annual wellness visit: The differences explained

While both types of the annual physical and an Annual Wellness Visit (AWV) have prevention in mind, there are many differences between them.

Visually check the patient’s body overall for signs of existing health issues

Renee Dowling is a compliance auditor at Sansum Clinic, LLC, in Santa Barbara, Califronia.

Annual physical exams and Medicare Annual Wellness Visits (AWVs) serve different purposes in healthcare. An annual physical is a comprehensive, hands-on examination focusing on identifying existing health issues through physical exams and lab tests. In contrast, the AWV is a hands-off assessment aimed at prevention, identifying care gaps, and establishing a health baseline for future care. Medicare covers AWVs annually, focusing on personalized prevention plans, risk assessments, and screenings. While Medicare does not cover annual physicals, it does cover AWVs and many preventive screenings without copays or deductibles.

There are more differences than you might think.

The differences between a physical exam and an Annual Wellness Visit

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Why has innovation in health care not kept pace with other sectors of the economy? Harman Dhawan, founder and CEO of Bikham Healthcare, offers his take and some possible solutions. 

Is too much regulation stifling health care innovation? 

Every presidential election year, there’s an unrelenting media focus on how the outcome will affect the stock market.

It never fails. In one article after another, financial journalists inflict on their audiences unrestrained speculation about how the stock market may fare as a result of one political party winning the White House versus the other.

These commentaries never suggest that the election outcome may not make much difference, as they follow a hallowed journalistic axiom: Never discount the thesis (or assumption) driving a story because, of course, that story 

 be done, regardless of how shaky its basis may be.

An old newspaper adage comes to mind — one that’s common in screenplays of newspaper movies from the 1930s and 1940s: “Never let the facts get in the way of a good story.”

In this case, the inconvenient fact that gets in the way is that it historically hasn’t really mattered for the market which party wins the presidency. This has been true for the better part of a century.

During presidential administrations since Eisenhower, the 

mean compound annual growth rate of the S&P 500 index of large company stocks

. But the median growth rate has averaged 8.5% during Democratic administrations and 10.2% for Republicans.

So media speculation over how a presidential victory by either party would make a real difference in the market during their administrations is much ado about nothing, with a quadrennial din of political noise combined with market noise.

Investors are always better off ignoring noise (in favor of data) when managing long-term portfolios, and political noise is no exception.

However, investors interested in adding to stock positions at discounted prices may not want to ignore the fact that an election is about to be held, as this alone usually has a significant impact on short-term market performance. Recurring election-season market patterns often create buying opportunities.

Election years are highly volatile for the market, and heightened volatility in the autumn of those years is almost as predictable as leaves changing color.

On average, in presidential election years 

, the S&P 500 has risen several percentage points in the summer before declining in the fall — for losses in September and October: -0.3% and -0.5%, respectively. Over the last 10 years, the dip has averaged 2.31%.

Once elections are over, this index has usually headed upward again, gaining an average of 1.2% in November and 1.5% in December. And it usually continues heading upward in January.

So cashing out of the market in the fall is usually a losing strategy, while buying (low) post-election can often position investors for solid gains the following year — especially amid a bull market like the current one.

In many past election years, the early fall dip started in September, but that hasn’t turned out to be the case this year, as the market was that month. Yet, if past pre-election autumn averages manifest again, a pre-election decline would likely occur in October — before bouncing upward in November.

The timing of this historically average post-election bounce may seem like a head-scratcher, as it’s usually unclear before presidents take office precisely what policies may be forthcoming, campaign promises being what they are.

Yet, while this specific uncertainty may linger, general uncertainty over the election outcome is over after the votes are counted.

So normal trading resumes, pushing up markets already inclined to rise from longer-term factors.

Media speculation about presidential elections' impact on the stock market often overlooks historical data showing minimal long-term differences based on which party wins. Historically, the S&P 500's performance has been similar under both Democratic and Republican administrations. However, election years are marked by predictable market volatility, creating potential buying opportunities. Post-election, markets typically rebound, with financials and technology sectors often outperforming. The Federal Reserve's rate cuts and potential cash inflows from money market accounts could further bolster stock prices, especially if the market dips before the election.

POTUS election outcomes don’t typically affect stocks long term, but their uncertainty often has short term impacts.

Atul Pathiyal, MPH

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