Physicians Advocacy Institute (PAI)
The Physicians Advocacy Institute’s mission is to advance fair and transparent payment policies and contractual practices by payers and others in order to sustain the profession of medicine for the benefit of patients. MSNJ’s CEO, Lawrence Downs, is a member of PAI’s Physicians Advocacy Liaison Committee.
Medical Audit Toolkit
The Physicians Advocacy Institute (PAI) and American College of Emergency Physicians (ACEP) have published a Toolkit for Physicians Facing Medical Audits. Medical Society of New Jersey (MSNJ) has partnered with PAI and ACEP to disseminate this Toolkit, which provides valuable resources for physicians.
Additional Medical Audit Resources
NEW: PAI Study on the Impact of Physician Employment Trends on Medicare Beneficiaries
The Physicians Advocacy Institute (PAI), of which MSNJ is a founding member, released a new study "Implications of Hospital Employment of Physicians on Medicare & Beneficiaries" on how the increase in physician employment over a three year period between 2012-2015 impacted Medicare spending, including beneficiary spending. The report shows Medicare paid $2.7 billion more for procedures performed by employed physicians than if those physicians would have been independent, based on the practice patterns of both groups. Beneficiary expenses were $411 million more than if the physicians were independent. Read the study and press release.
Report Reveals Increased Hospital Ownership of Physician Practices
The Physicians Advocacy Institute (PAI), of which MSNJ is a founding member, released a new study "Physician Practice Acquisition Study: National and Regional Employment Changes" on the rate of acquisitions of physician practices by hospitals and health systems between 2012 and 2015. The report shows a significant nationwide increase in the number of physicians leaving private practice and entering into employment arrangements with hospitals and health systems. Of note:
- The number of practices owned by hospitals and health systems rose nearly 90%;
- 38% of physicians were employed by hospital or health systems, up from one in four in 2012.
Read the press release, study and news coverage.
Physician Practice Based Services Less Costly than Hospital Outpatient Department
A new report by researchers at Avalere Health, released by the Physicians Advocacy Institute (PAI), finds that cardiac imaging services cost three times as much in a hospital outpatient department as in a physician's office. The "Medicare Payment Differentials Across Outpatient Settings of Care" report compared Medicare payments for three common procedures, echocardiograms, colonoscopies, and evaluation and management services and found that all were less costly in a physician's office. And, for the first time, this study looked at Medicare payments for entire episodes of care for certain procedures and found them less costly in a physician's office. PAI has provided the report to the House Energy & Commerce Committee, including ranking member Frank Pallone, Jr., in response to its request for information on implementing a new Medicare policy that would establish "site neutral" payments. Read Health Leaders Media coverage. Read more.