The fee section of a payer contract can be confusing and ambiguous. Amounts are often stated as a percentage of the Medicare fee schedule. Well, is that geographically adjusted or geographically unadjusted Medicare rates? Are the percentages based on current Medicare rates? Providers need to know allowable fee schedules for all of the services they provide.

Escalating costs and stagnant reimbursement force many medical practices to turn to hospitals for financial help with physician recruitment. In turn, community hospitals find it increasingly difficult to attract needed specialists. Small medical groups have few options under the Stark law. In most cases, employment by the hospital or a hospital-owned subsidiary medical practice is the only viable approach to recruitment.

"Does anyone have a bonus/incentive plan tied to the productivity or the net income of the practice? Are you happy with the plan or unhappy?”

Physician work-force needs have always been hard to predict because they are affected by patient demographics, technology
changes, payment policies and other issues. The demographic picture is scary. Beginning in 2011, the first of the baby boomers will turn 65 and become Medicareeligible. As a consequence, demand for medical care is likely to soar. But the often overlooked fact is that a number of those baby boomers are physicians who will leave the work force just as demand for their services climbs.