As practice costs soar and more physicians transition to employed models, financial stability and physician autonomy often seem at odds.
Pradnya Mitroo, MD, president of Fresno (Calif.) Digestive Health, joined Becker’s to discuss how she feels the future of independent practice lies in innovative hybrid models that balance both.
“Some physicians feel that employed models with larger organizations, whether it be hospital or PE- backed groups, offer more financial stability,” Dr. Mitroo said. “Hospitals and PE-backed groups offer guaranteed salaries and benefits reducing financial risks for physicians and they have greater bargaining power with insurance companies to get better reimbursement rates. However, both of these models decrease physician autonomy.”
Today, about 77% of physicians have left independent practice for employment with hospitals or health systems, often sacrificing the flexibility and control that come with private practice.
To navigate this challenge, Dr. Mitroo and her colleagues formed a large, physician-owned GI practice with a hybrid model across their two ASCs, she told Becker’s.
The first endoscopy center model is a “hybrid” model owned in conjunction with AmSurg. Although AmSurg is private equity-backed, physicians still have a lot of say in how it operates, Dr. Mitroo said. The model allows physicians to maintain autonomy while having the backing of a national company.
“In terms of economies of scale, it has helped with supply costs, contracting and insurance negotiations,” she said. “If we were trying to contract on our own, we definitely wouldn’t get the same advantages.”
Additionally, insurance contracts are “significantly better under this model,” Dr. Mitroo said.
Reimbursement cuts remained a pressing challenge. However, prompting the group to explore a new hybrid model for expansion — this time integrating both AmSurg and a hospital partner.
The collaboration offers higher reimbursement rates than an independent ASC while keeping costs lower for patients compared to full hospital settings, Dr. Mitroo said.
“It’s an in-between model — higher reimbursement than our original ASC, but not as expensive for patients as a hospital setting,” she said.
For independent physicians considering similar partnerships, Dr. Mitroo emphasizes the importance of selecting the right collaborators.
“You need a partner that shares your goal of high-quality care and isn’t just looking for another revenue stream,” she said. “Our hospital partner helps with contracts but remains a silent partner in operations — ensuring we maintain efficiency and autonomy.”
