Becker's ASC Review

16 ASC Management that can leverage payer contracts. His practice, Sports Medicine Specialists of Charleston, is af- filiated with the East Cooper Medical Center in Mount Pleasant, S.C., and he serves as the direc- tor of sports medicine at the hospital. "Hospitals oen can negotiate better payer rates," says Dr. Geier. "e hard part [of being indepen- dent] seems to me, the rising overhead and data needed for the government and insurance." With better payer rates, an employed physician may re- ceive better reimbursements. Ms. Jameson argues better payer rates, however, equates to higher costs for consumers. Dr. Geier agrees with Ms. Jameson that a referral base will make or break a private practice. From Dr. Geier's experience however, sometimes the only way to survive is by joining a hospital. "If a lot of other groups around you are join- ing hospital employment, you have to refer to that hospital," says Dr. Geier. "Your referral base would dry up if you didn't join the hospital." Although Dr. Geier acknowledges tighter restric- tions and more uniformity in the hospital setting, he doesn't think employed physicians throw qual- ity of care to the wayside. "You just have to be at a place that really cares about patient satisfaction," he says. As for the future, Dr. Geier doesn't see the health- care industry experiencing another drastic change anytime soon. "We may get to an equilibrium and it may settle at that point," says Dr. Geier. "But it's hard to see a situation where [the trend] goes back the other way." n Dr. David Geier Dr. Richard Kube Marni Jameson 17 Things to Know About Ambulatory EHRs By Carrie Pallardy E pic, Cerner athenahealth and eClinicalWorks dominate overall mind- share when it comes to the ambulatory EHR market, according to peer60's Trends & Insights in Ambulatory EHR First Reaction Report. Here are 17 things to know about vendor mindshare and market share in the ambulatory EHR space. Hospital-owned facilities 1. Epic has slightly more than 20 percent of the market, but nearly 40 per- cent mindshare. 2. Cerner has a 14 percent market share, but breaks even with Epic when it comes to mindshare. 3. MEDITECH has an 11 percent market share; Allscripts has a 10 percent market share; and Greenway has a 5 percent market share. But, these com- panies do not register when it comes to mindshare. 4. McKesson has an 8 percent market share and 9 percent mindshare. NextGen has a 3 percent market share and a 9 percent mindshare. 5. athenahealth has just 3 percent of the market, but ranks high in mind- share at 23 percent. Independently-owned facilities 6. NextGen holds the highest market share with 18 percent, but it does not register when it comes to mindshare. 7. Epic has a 15 percent market share, but 22 percent mindshare. 8. Cerner has 10 percent of the market, but again ranks alongside Epic at 22 percent when it comes to mindshare. 9. eClinicalWorks has just 5 percent of the market, but ranks the highest when it comes to mindshare at 33 percent. 10. McKesson has 7 percent of the market, but does not have much trac- tion when it comes to mindshare. 11. Allscripts and athenahealth break even in mindshare at 11 percent each. Allscripts has 4 percent market share, while athenahealth has 3 percent. Biggest EHR challenges 12. More than half of the survey's respondents (55 percent) indicate a miss- ing functionality is the biggest challenge they face with their current EHR. 13. Just less than half of respondents (42 percent) point to usability as the biggest challenge. 14. irty percent of respondents say support for their strategic objectives is an obstacle. 15. Service is a key issue for 21 percent of respondents. 16. For 12 percent of respondents, reliability ranks high on the list of chal- lenges. 17. irteen percent of respondents list "other" as a challenge, while just 14 percent of respondents report no challenges. n

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