Emergency Department Visits Dominated by Non-Physician Employers

Strategic Insights -

The American College of Emergency Physicians (ACEP) has released findings from a first-of-its-kind analysis of physician group market share by ownership structure in emergency medicine. The study, published in Annals of Emergency Medicine, reveals that most emergency department visits are staffed by physicians employed by health systems or private equity-owned staffing groups. According to lead study author Angela G. Cai, MD, MBA, a shared understanding of market trends can inform efforts to improve physician work conditions and strengthen care delivery.

Key Takeaways:

  • Health system-owned groups staffed a third (33%) of all emergency visits.
  • Private equity-owned groups staffed nearly one in four (24.7%) of visits.
  • Regional clinician partnership-owned groups accounted for 20.8% of visits.
  • National clinician-owned partnership groups were 13.4% of visits.
  • Single site clinician partnership-owned groups staffed 8.1% of visits.
  • The study included 3,998 hospital-based emergency departments accounting for 109.7 million visits.
  • In the private equity ownership category, 93% of all ED visits were seen by physicians under three employers.
  • Regional concentration is high, with 84% of 306 hospital referral regions across the country qualifying as highly concentrated.
  • Emergency physicians continue to raise concerns about care quality and workplace satisfaction as consolidation increases.

Statistics:

  • 109.7 million visits were accounted for by the 3,998 hospital-based emergency departments in the study sample.
  • 33% of emergency department visits were staffed by health system-owned groups.
  • 24.7% of visits were staffed by private equity-owned groups.
  • 20.8% of visits were staffed by regional clinician partnership-owned groups.
  • 13.4% of visits were staffed by national clinician partnership-owned groups.
  • 8.1% of visits were staffed by single site clinician partnership-owned groups.
  • 93% of all ED visits in the private equity ownership category were seen by physicians under three employers.
  • 84% of 306 hospital referral regions across the country qualified as highly concentrated.

Sources:

  • American College of Emergency Physicians (ACEP)
  • Annals of Emergency Medicine