Insurance Clouds Future of Pa. Health System, Study Claims

April 9, 2006

Health care plays a significant role in Pennsylvania’s economy; however, the future of patient care is uncertain as problems with insurance and supply of services as well as increased demand for care combine to severely stress the system.

The number of permanent full-time doctros is dropping and b 2010, Pennsylvania could face a shortfall of nearly 10,000 physicians, the study issued by the Pennsylvania Medical Society found.

According to the 120-page report, unprecedented demand for health care services in the country, particularly Pennsylvania, has placed the health care delivery system under significant pressure from many directions.

Among the study’s key findings:

* In 2003, health care represented 11.7 percent of all U.S. non-governmental jobs. In Pennsylvania, the percentage was 14 percent.

* In 2004, hospitals, physicians, health insurers, home health care providers, nursing homes, and prescription drugs accounted for 12 percent of Pennsylvania’s $464 billion gross state product.

* In 2004, Pennsylvania had about 2.1 million Medicare beneficiaries and about 1.7 million Medicaid recipients.

* In 2004, the number of uninsured in Pennsylvania was between 900,000 and 1.5 million.

* Commercial health insurance enrollment in Pennsylvania declined from 7.1 million lives in 2000 to 5.4 million lives in 2005.

* The financial health of Pennsylvania’s health insurers is vital to citizens of the commonwealth; however, Pennsylvania health insurance premiums are higher than the rest of the U.S. and are increasing at greater rates.

* Pennsylvania hospital admissions are on the rise.

* Because of Pennsylvania’s aging population, Pennsylvania physicians see more Medicare patients than most other states.

* Between 1999 and 2005, the top 20 most populous states saw a 15 to 35 percent increase in the number of physicians with a Medicare unique physician identification number permitting them to bill for Medicare services and refer Medicare patients. However, Pennsylvania saw a 10 percent decline.

* Pennsylvania Mcare Fund data indicate that the number of permanent full-time equivalent physicians has fallen from 36,500 in 1998 to 32,000 in 2004.

* The percentage of part-time permanent physicians has increased from 6 percent to 16.5 percent of the physician work force.

* In 2004, only 7.8 percent of Pennsylvania doctors-in-training stayed in Pennsylvania after completing residency, down from 50.5 percent in 1994.

* In 2004, the National Practitioner Data Bank documented Pennsylvania physician liability insurance payouts of $450 million, up from $180 million in 1991.

* By 2010, Pennsylvania could face a shortfall of nearly 10,000 physicians based upon current trends related to supply and demand.

“The State of Medicine in Pennsylvania – 2005″ report comes after a nine-month analysis of various data sources related to physician services.

” This report is not intended to play politics and the medical society intentionally did not draw conclusions or present solutions,” said Pennsylvania Medical Society President Mark A. Piasio, M.D., an orthopedic surgeon from DuBois. “This is concrete evidence that hopefully will initiate discussion with stakeholders on how to best preserve patient access to quality care.”

Piasio said that the Pennsylvania Medical Society will organize a statewide summit to open discussion of the report’s findings.

The lead researcher on the report was Stephen Foreman, Ph.D., J.D., M.P.A., who serves as associate professor of health economics and allied health at Robert Morris University in Pittsburgh.

For a copy of the report’s executive summary or to order a copy of the full report, visit www.pamedsoc.org/SoM.

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