PPACA payment reform scatters specialists

(AP Photo/Jim Salter, File)

The government set a timetable last week to extinguish Medicare’s “fee-for-service” system, which rewards the quantity of care over quality. That’s adding to pressure on physicians who have been debating whether to join their local hospital, merge their practices into ever-bigger groups or get out of medicine.

Specialists warn that patients in some areas of the country may have difficulty finding their services as small, rural practices close and the doctors join larger companies. Just 35 percent of physicians described their practices as independent in a 2014 survey, down from 62 percent in 2008, according to the Physicians Foundation, a nonprofit advocacy group for the profession.