Honorários praticados por operadoras de planos odontológicos e pelo SUS em relação aos definidos pelo Conselho Federal de Odontologia / Fees charged by dental insurance companies and SUS as compared to those defined by the Brazilian Federal Dental Council

Objetivo: Investigou-se o repasse de honorário ao cirurgião-dentista ofertado pelas empresas operadoras de planos odontológicos por grupos de procedimentos odontológicos. Materiais e Métodos: Os valores praticados por operadoras de planos foram definidos a partir da média obtida entre valores das tabelas de cinco planos com abrangência nacional. Esses valores médios e os valores pagos pelo SUS foram comparados com os estabelecidos na tabela VRCC – CFO. Para a comparação, foram obtidos valores médios para os seguintes grupos de procedimentos: preventivos, de dentística, de endodontia e de cirurgia.Os valores dos procedimentos preventivos foram comparados com os demais grupos de procedimentos. Resultados: Os planos aplicaram um desconto médio de 54,51% sobre os preços sugeridos pelo CFO. O maior desconto foi observado no grupo de procedimentos preventivos (57,09%, em média). Conclusão: As empresas operadoras de planos e convênios investigadas estão aplicando um desconto abusivo sob os preços sugeridos pelo CFO. É necessário identificar alternativas para que se possam reverter o quadro identificado por esse estudo.

The Monte Carlo method improves physician practice valuation.

This article demonstrates the use of the Monte Carlo simulation method in physician practice valuation. The Monte Carlo method allows the valuator to incorporate probability ranges into the discounted cash flow model and obtain an output indicating the probability for specified ranges of practice valuation. Given the high level of uncertainty in projected cash flows associated with physician practices, the value of this kind of information in a practice valuation decision would quite obviously be superior to any single point estimate generated by a traditional discounted cash flow model. It is postulated that virtually all hospitals support an information system that can easily accommodate a Monte Carlo simulation.

Successful physician-hospital integration in rural areas.

OBJECTIVES: During the 1990s hospitals competed to acquire physician practices. Those competitive bidding wars could have pushed the price of practices beyond the value obtained by gaining influence over physicians. This paper examines how hospital location and competition for physician practices affects the profitability of physician-hospital integration in rural areas. MATERIALS AND METHODS: Eight years of data covering 338 rural hospitals are used to test whether the acquisition of physician practices is more successful in more isolated, uncompetitive rural markets than in competitive rural markets. A hospital without a competitor within a 15-mile radius is deemed to operate in an uncompetitive market. Success is measured by shifts in admissions, lengths of stay, and overall profitability following the acquisition of a physician practice. RESULTS: Hospitals in uncompetitive rural markets that acquired practices showed decreased lengths of stay and increased admissions with no reduction in profitability. Hospitals in more competitive rural markets that acquired practices showed a decrease in profitability. CONCLUSIONS: Integration was a more profitable strategy for isolated rural hospitals than for hospitals with nearby competitors. Although further research is needed to determine if these results are due to the affect of competition on the cost of acquiring and operating practices, isolated rural hospitals should be open to the prospect of acquiring physician practices. Hospitals in competitive markets should be cautious about entering bidding wars for physician practices.

Why do rural primary care physicians sell their practices?

This study evaluates why rural primary care physicians sell their practices. A random sample of rural primary care practices in California, Utah, Ohio, Texas, and Virginia were surveyed to investigate changes in ownership of the practices during the period 1995-1998. These five states were selected because they represent areas with different experiences with physician-hospital integration and varied rates of managed care penetration. A series of logistic regressions were conducted to examine the factors that led independent physicians to sell their practices to either nonlocal buyers, local hospitals, or local physicians. Findings suggest that sales to nonlocal buyers represent the majority of practice ownership changes. The motivations for ceding control to nonlocal buyers center on managed care concerns, recruitment concerns, and administrative burdens. Sellers were also concerned about their level of net income prior to being acquired. However, the preacquisition financial concerns of sellers were not significantly stronger than the financial concerns of practices that remained independent. The environmental conditions that motivate rural physicians to sell their practices are not expected to improve. Therefore, additional sales of rural primary care practices to nonlocal buyers are expected. Further research is necessary to determine whether this shift in control will lead to changes in the quality or accessibility of care.

Buy vs. bye.

At first, the retreat of practice management companies looked like a great opening for hospitals. What better way to acquire prime medical groups from motivated sellers? Trouble is, you still need a motivated buyer. That's why some observers contend hospitals will purchase only a fraction of medical groups being divested by MedPartners and other retrenching firms.

Practicing restraint.

Binge buying of medical practices has entered rehab, according to an analysis by the Center for Healthcare Industry Performance Studies. For hospitals, that's meant a shift to acquiring more profitable practices. On top of that, they're putting more physician pay at risk and tying it to productivity.

Retirement from orthodontics: financial and psychosocial preparation and adaptation.

Retired members of the Pacific Coast Society of Orthodontists (n = 231) were surveyed with respect to their financial and psychosocial preparation for, and adaptation to, retirement. Statistical and subjective evaluation of the survey results established that the respondents used a variety of strategies in divesting themselves of their practices and other aspects of professional life. The respondents reported a relatively high level of accumulated wealth and general satisfaction with retirement as a result of a sense of financial security as well as continued active participation in diverse recreational, social, avocational, business, family, and community activities. Early anticipation of and planning for all aspects of the retirement experience enhanced the likelihood of a satisfactory outcome.