2019 HSC Section 2 - Practice Management

TABLE I. ( Continued)

No.

%

Does access to an ASC reduce healthcare costs for your patients? Answer choices Yes

57

93%

No

4

7%

Is there a benefit contracting with private payors and having access to an ASC? Answer choices No benefit

14

23%

Small benefit

16

26%

Moderate benefit

15

25%

Significant benefit

16

26%

What percentage of your cases do you perform at the ASC?

62%

Do you see that percentage increasing? Answer choices Yes

24

39%

No

25

41%

Not really sure

12

20%

ABR 5

auditory brainstem response; ASC 5

ambulatory surgery center; CT 5

computed tomography; CON 5

certificate of need; EMR 5

electronic medical

records; ENG 5

electronystagmography; ENT 5

ear, nose, and throat; HOPD 5

hospital outpatient department.

practice model (52% and 50%, respectively). Audiology extenders, oto-techs, were utilized in 24% of all otolaryn- gology practices and predominantly reported within 71% of seven to nine–physician groups. Fifty percent of those reporting use of oto-techs also employed two to three audiologists In-office point-of-service (POS) ancillary services were reported being utilized by all respondents. Audio- logic services were performed in 100% of practices with the minimum reported service being diagnostic audio- grams. More advanced audiometric testing included 86% providing otoacoustic emissions and 63% auditory brain- stem responses (ABRs). Sedated ABRs were the least commonly performed of all the audiologic services, offered by only 23% of respondents. The majority of practices performing sedated ABRs were larger practices with more than 13 otolaryngologists within AGO or large MSSO models. Electronystagmography (ENG) test- ing was reported within 76% of respondent’s practices. Hearing aid sales and services represented the second most common of any ancillary service, reported within 93% of otolaryngologist’s practices. POS in-office computed tomography (CT) and ultra- sound (U/S) were reported within 63% and 50% of respondent’s practices, respectively. Stratifying by group size, despite the capital intensive investment for POS CT, even smaller groups reported integration of CT serv- ices, as reported by 17% of solo practitioners and 47% of the two to three–physician groups. Less commonly reported were POS laryngoesopha- geal services, with manometry and pH probes being utilized in 11% and 12% of all reported physician offi- ces, with the majority being performed within aca- demic practices (36% and 21%, respectively). POS

commonly reported (55%) and was the most commonly reported group model for physicians practicing over 10 years. Academic group otolaryngologist (AGO), defined as practicing within a university academic department, made up 16% of respondents A total of 14% of respond- ents were hospital-employed physicians working < 5 years and who had the highest reported level of hospital employment. In terms of practice size, 74% of physicians reported working in a group of four or more otolaryngologist, with 17% reporting a group size of more than 21. The mean group size was the seven to nine physician group model. Solo practitioners made up only 18% of respond- ents. No physicians practicing for < 5 years reported being in solo practice as compared to 25% of physicians practicing between 21 and 25 years and 30% of physi- cians practicing > 25 years. For physicians practicing < 5 years, 50% were in two to three–physician groups, and 33% were in the 16 to 20–physician group model. The number of offices reported within each practice found that 74% of reporting physicians had more than one office, with 21% greater than five offices and 61% reporting offices in more than one city. The mean num- ber of offices reported across all respondents was 2.71. Employment of physician assistants (PAs) within an otolaryngology practice was reported by 50% of respond- ents. Of note, nurse practitioners (NPs) were less com- monly employed, reported by only 31% of respondents. Controlling for group practice model, 89% of solo SSGO practitioners reported using no practice extenders within their practice. The largest utilizers of otolaryngology practice extenders (PAs and NPs) were reported within the multi-surgical specialty otolaryngolgist (MSSO) model (83% and 67%, respectively), followed by the AGO

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