Becker's Hospital Review

20 CFO / FINANCE Most patients don't shop around before physician-recommended MRIs, researchers find By Kelly Gooch P atients often receive nonemergency, outpatient, lower-limb MRI scans where their referring physician recommends, despite poten- tially higher out-of-pocket costs, according to a National Bureau of Economic Research working paper. The study — conducted by researchers from New Haven, Conn.-based Yale University, Boston-based Harvard Medical School and New York City-based Columbia University — examined how privately insured individuals pick providers for lower-limb MRI scans. It involved more than 50,000 adults 19 to 64 years old, according to The New York Times. Researchers said they found patients often received scans in more ex- pensive locations when there were less expensive options. The study also found fewer than 1 percent of people used a price transparency tool to shop around before getting the MRIs. The findings suggest referring physicians have a significant effect on where their patients receive care, the researchers concluded. "The influence of referring physicians is dramatically greater than the ef- fect of patient cost-sharing," they said. "As a result, in order to lower out- of-pocket costs and reduce total MRI spending, patients must diverge from the established referral pathways of their referring physicians. We also observe that patients with vertically integrated [hospital-owned] re- ferring physicians are more likely to have hospital-based [and more cost- ly] MRI scans." n Only 43% of physicians know their compensation includes value-based pay By Megan Knowles L ess than half — 43 percent — of phy- sicians are sure at least some of their pay is value-based, and about half of those physicians say this portion is 10 per- cent or less of their total compensation, a report from The Medicus Firm found. Medicus, a national physician search firm, conducted a survey in May to gain insight on physician compensation, career satisfaction, practice preferences, concerns and more. A total of 2,219 medical professionals participated, including physicians and ad- vanced practice clinicians in over 20 med- ical specialties. Medicus conducts the sur- vey annually. The value-based compensation finding shows little progress from last year's sur- vey, which found about 41 percent of phy- sicians were certain any portion of their pay was value-based. n Mon Health plans turnaround after losing nearly $27M in 2018 By Alyssa Rege and Kelly Gooch M on Health ended fiscal year 2018 in the red, but the Mor- gantown, W.Va.-based system aims to turn around its fi- nances through an operations improvement plan, accord- ing to e Dominion Post. Here are five things to know: 1. Mon Health incurred an operating loss of $26.5 million by the end of its 2018 fiscal year, which ended June 30, according to internal financial documents obtained by e Dominion Post and discussions with interim CEO Tom Senker. 2. e system also saw patient volume fall roughly 9 to 10 percent during the last 12 to 18 months, Mr. Senker told e Dominion Post. However, despite systemwide losses, Morgantown-based Mon Health Medical Center ended fiscal year 2018 with a $7.5 million surplus. 3. Several factors contributed to Mon Health's troubling finances, including hiring costs, competition in secondary markets and "ex- ecutive management changes," the report states. One such change involved Darryl Duncan, the former CEO of Mon Health, who was placed on leave in February aer more than 20 Mon Health Medi- cal Center physicians signed a letter of no confidence in him. Mr. Duncan officially resigned from the system in March. In July, he was accused of harassing his replacement. 4. Health system officials said in July they had begun implementing an operations improvement plan to help improve the system's fi- nances. e measure involved several components and departments, including the system's human resources and finance divisions, phar- macy, revenue cycle, physician practice and workforce efficiency. As part of the plan, officials also canceled employee pay raises for one year — a move that went into effect July 15. 5. Mr. Senker told e Dominion Post the measures in place will hopefully help the system break even in fiscal year 2019. n

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