title: Costs of providing primary care: comparison of an academic general medicine practice with an MGMA benchmark.
abstract: Market-based healthcare reform has placed great financial pressures on academic departments of internal medicine. The current emphasis and increased recruiting for primary care have not been accompanied by a financially supportive institutional culture or favorable third-party reimbursement system for the generalist practitioners. In one department's analysis, there was a large difference in revenue (-$130,000) compared to a Medical Group Management Association (MGMA) standard, yet a reduced level of compensation for primary-care physicians, $61,000 less per full-time equivalent (FTE). Total overhead per FTE in our department was $80,000 greater than comparable practices of the MGMA standard. We have estimated the institutional strategic costs of having primary-care clinics in three separate locations in the city of Richmond ($74,000/FTE). No viable cost-cutting options placed the primary-care program in positive balance, but the analysis contributed to a creative institutional approach for a solution.
authors.affiliation: Department of Internal Medicine, Medical College of Virginia, Virginia Commonwealth University, Richmond, USA.
authors.forename: R P
authors.initials: RP
authors.lastname: Wenzel
authors.forename: J
authors.initials: J
authors.lastname: Girtman
authors.forename: D
authors.initials: D
authors.lastname: Costello
authors.forename: M D
authors.initials: MD
authors.lastname: Nettleman
mesh_terms: D000046:Academic Medical Centers / Q000191:economics*; D019985:Benchmarking / Q000191:economics*; D003363:Cost Control; D005378:Financial Support; D017721:Hospital Costs / Q000706:statistics & numerical data*; D007182:Income; D007349:Insurance, Health, Reimbursement; D007388:Internal Medicine / Q000191:economics*; D010044:Outpatient Clinics, Hospital / Q000191:economics; D011320:Primary Health Care / Q000191:economics*; D014768:Virginia