American Association of Neurological Surgeons President William T. Couldwell, MD, gave his perspective on the changing landscape of surgeon employment in a recent edition of AANS Neurosurgeon.
While he noted that 60 percent of American College of Surgeons fellows are now hospital-employed and the factors driving physicians to hospital employment, he also discussed his personal perspective and considerations for neurological surgeons before choosing employment or accountable care organizations.
1. Within ACOs, hospitals are paid a fixed amount and neurological surgery could be a high-cost liability instead of a high-paying specialty.
2. Not all physicians are able to deliver quality care, so choose partners wisely.
3. Hospitals often control the distribution of income for ACO members, and neurosurgeons may need to defend the relative value of their contribution.
4. Neurosurgeons can take steps to reduce costs and enhance profitability.
5. When the ACO achieves its goals to provide higher quality care at a lower cost, insurance companies have little incentive to increase resources over time.
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