Understanding the integration of physicians within hospital systems can be complex. While some physicians are independent or employees, others may have affiliations with hospitals without being employed by them. Various methods can be used to measure physician integration within a hospital system:
- Basic TIN-based measure: This approach looks at whether a physician primarily bills using a hospital-related tax identification number (TIN).
- Service location measure: Examines where outpatient services are provided, in a physician’s office or hospital-based outpatient department.
- Affiliation based approaches: Focus on the physician’s affiliations with hospitals.
- “Advanced” TIN measure: A more detailed approach proposed by Luo et al., which involves multiple steps in identifying integrated physicians.
Using these approaches, research indicates a rising trend in physician integration within hospital systems over time. One study found that the percentage of physicians integrated into hospitals increased from 19.5% in 1999 to 43.5% in 2019. This trend is reflected in the graph below:
For more detailed information on this topic, refer to the study linked above. The methods summary figure can be viewed below:
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