UMEM Educational Pearls - By Steve Schenkel

Title: Emergency Medicine Staffing Group Structures

Keywords: staffing, employment, Teamhealth, Medstar, Edelman (PubMed Search)

Posted: 3/16/2024 by Steve Schenkel, MD (Emailed: 4/17/2024) (Updated: 4/17/2024)
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Emergency Medicine staffing groups can be organized in any number of ways. Here’s Leon Adelman’s take:

There are EDs staffed by non-physician-owned corporations. The two largest of these are Teamhealth and the restructured Envision, owned by Blackstone and a consortium of investors, respectively.
Then there are physician-owned groups. The largest of these is USACS, but these range in size from staffing for a single ED to USACS’ 297 EDs.
A third of EDs are staffed directly by health systems, think Medstar locally. This is probably also the category Edelman uses for academic centers, though physicians may be employed by a separate faculty practice or by the medical school instead of the hospital.

Read more at https://emworkforce.substack.com/p/state-of-the-us-emergency-medicine-677. Read closely and you’ll find a reference to Maryland.

Category: Administration

Title: Employee or Independent Contractor?

Keywords: employee, independent contractor, employment, job market (PubMed Search)

Posted: 1/12/2024 by Steve Schenkel, MD (Emailed: 2/28/2024) (Updated: 2/28/2024)
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The relationship between an Emergency Physician and the hiring group (whether large or small) may be one of employer-employee or contactor-independent contractor. There are legal job protections for employees that don’t exist for independent contractors. There are also regulations that define an independent contractor. Enforcement of these regulations varies but may be increasing. This has implications for the Emergency Medicine job market. We have the highest percentage of independent contractors of any medical specialty.

See more at Leon Adelman’s Emergency Medicine Workforce Newsletter, here https://emworkforce.substack.com/p/thousands-of-employed-emergency-physicians

Category: Administration

Title: Medicare Advantage - Why it matters

Keywords: Medicare advantage, insurance, payor (PubMed Search)

Posted: 1/12/2024 by Steve Schenkel, MD (Emailed: 1/30/2024) (Updated: 1/30/2024)
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Approximately half of all Medicare beneficiaries are now enrolled in Medicare Advantage plans. Why does this matter?

Traditional insurers (for example, United & Blue Cross) run Medicare Advantage (MA) plans. The federal government pays the insurers. This is different from Traditional Medicare which the Federal Government both funds and runs.
MA plans may include prescription drug, vision, and dental care. They also often include out-of-pocket caps.
MA plans may limit flexibility in provider choice with in-network and out-of-network provisions.
So far, MA costs the federal government more than traditional Medicare.

Intrigued? Learn more at https://www.nejm.org/doi/full/10.1056/NEJMhpr2302315 or https://www.kff.org/medicare/issue-brief/medicare-advantage-2024-spotlight-first-look/.