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What do hospitalists think about Obamacare?

January 2014

Published in the January 2014 issue of Today’s Hospitalist

ACCORDING TO THE RESULTS of the 2013 Today’s Hospitalist Compensation & Career Survey, just under half of hospitalists (45%) said they support the Affordable Care Act, while just under a third (29%) said they do not. (About one-quarter “26.5% “reported being neutral on the topic.) Here’s more about what hospitalists think about this version of health care reform.

Who likes it and who doesn’t?
Support for the act was higher among pediatric hospitalists (54% said they supported Obamacare) than adult hospitalists (44%). Support was also stronger among part-time hospitalists (51%) than full-time physicians (44%), and among hospitalists working at medical schools/universities (59%) and teaching hospitals (50%).

Support for the act was lowest among hospitalists working for local hospitalist groups (38.1% said they don’t support it) and among physicians whose pay is based solely on productivity. Among those hospitalists, 41% said they don’t support the new law.

Finally, the more hospitalists reported earning in compensation, the less likely they were to support Obamacare. While 23% of hospitalists earning between $200,000 and $249,000 said they don’t support the act, that percentage jumped to 42% for hospitalists earning $300,000-plus.

Just over half of all hospitalists (52%) said they expect hospital admissions to rise as a result of the act, while 78% said they expect to spend more time on transitional care. When we asked how the act would affect the amount of income hospitalists see from quality incentives, 40% thought that amount would rise, while 27% thought it would decrease and 33% thought it would stay the same.

As for how the act might affect hospitalists, there is a considerable amount of pessimism in the specialty, both among those who support the law and those who don’t. Even hospitalists in favor of Obamacare said they expect reduced reimbursement for hospitalists, an increased workload and more regulations.

Among hospitalists who said they did not support the act, many said they expect significant problems meeting regulations and documentation requirements. They also said they expected the quality of care to suffer and health care costs to rise.