The number of physicians owning and operating their own medical practice has decreased considerably over the past fifteen years. According to the most recent surveys of Kentucky physicians, only 30% - 35% consider themselves to be the owner/operator of a medical practice in Kentucky. These numbers appear to be consistent with national figures as well.

But this still leaves many Kentucky physicians owning/operating their own medical practices. The Kentucky Medical Association would like to obtain information from these practices to find general trends and burdens to see how KMA might support relieving such burdens.

If you are an owner/operator/administrator of a medical practice in Kentucky wholly owned by one or more physicians in the practice, we would appreciate your completion of this survey. When asking for specific data, if it is not readily available, we ask that you provide subjective information.

KMA thanks you for your time in completing this survey.
Demographic Questions

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* 1. What is the primary specialty of your practice?

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* 2. How many physicians are there in your practice?

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* 3. How many full-time employees (FTE equivalents) does your practice have?

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* 4. Is your practice located in a rural or urban setting?

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* 5. What is your patient payor mix? (Ex: 50% Medicaid, 40% Medicare, 10% Commercial) (Please add up to 100%)

Issues Impacting Private Medical Practices

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* 6. Medical practices carry a variety of insurance policies to cover issues related to operating both a practice and a small business. Of the policies listed below, which have you had to purchase in the past five years that you previously did not purchase? (Click all that apply)

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* 7. Of the policies listed below, which ones have you had to change carriers in the past five years? (Click all that apply)

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* 8. Over the past five years, overall inflation for goods and services has risen just over 25%. Which of the insurance coverages for your practice listed below have risen more than 25% in the past five years? (Click all that apply)

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* 9. Is there a particular type of insurance you are unable to obtain for your practice and, if so, what kind of insurance?

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* 10. If yes to #9, were you unable to obtain the insurance due to cost or availability?

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* 11. Many medical practices contract with vendors outside the practice to perform certain functions for the practice. Please check those services that are provided to your practice by a company outside of the practice.

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* 12. Finding the appropriate personnel to work in a medical practice can be challenging. When hiring for an administrative position, how do you go about finding the appropriate person?

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* 13. What is the biggest challenge in trying to find administrative personnel to work in your practice?

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* 14. When hiring non-physician clinical staff for the practice, how do you go about finding the appropriate person?

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* 15. When hiring additional physicians, how do you go about finding the appropriate person?

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* 16. If your practice does offer a retirement plan to employees, what type of plan do you offer?

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* 17. An Independent Practice Association (IPA) is a group of independent physicians who work together to improve efficiencies and obtain contracts with employers, health plans, suppliers and others. Is your practice a member of an IPA?

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* 18. A Medical Services Organization (MSO) is a business organization that provides non-clinical services to medical practices including administrative, benefits, infrastructure, supplies, etc. Is your practice a member of an MSO or similar organization?

KMA conducted a survey in 2022 that concerned insurance billing concerns for physicians generally. The following questions ask for additional information regarding these issues.

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* 19. Over the past five years, have you seen a notable increase in the number of prior authorizations required by health insurers?

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* 20. Over the past five years, have you seen a notable increase in the number of insurance company recoupments from your practice?

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* 21. When appealing an insurer’s decision, have you been able to obtain a “peer-to-peer” review of the issue?

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* 22. Third party payers, whether commercial insurers or government payers, have a myriad of rules and requirements for physician practices to follow in order to get reimbursed for their services. If there was one such requirement specific to your practice or specialty that you could get modified, what would it be?

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* 23. Please name one third party payer requirement – whether imposed by a commercial or government payer – that you believe severely impedes patient care to the point of endangerment to the patient’s health.

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* 24. Does your practice currently participate with a government or commercial insurer in a value based contract? (Ex: A contract in which you’re compensated based on patient health outcomes and cost-efficiency, rather than the volume of services delivered.)

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* 25. If yes to #24, has the practice been satisfied with the arrangement compared to fee for service arrangements?

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* 26. Does anyone in your practice perform surgeries or other procedures outside the office setting? (If no, please skip to question 28)

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* 27. If anyone in your practice performs surgery outside the office setting, is it more difficult now than five years ago to obtain the use of an operating room or other setting to perform such procedures?

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* 28. If surgical procedures are performed within your office setting, has the practice experienced a notable increase in the cost of surgical supplies over the past five years?

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* 29. Are there any specific issues with the Medicaid program that could be addressed to strengthen independent physician practices?

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* 30. Please provide your email address if you wish to be entered into a drawing for one of three $50 Amazon gift cards. Your email address will not be shared or used for any other purposes.

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