Evolution of Physician-Centric Business Models Under Patient Protection and Affordable Care Act

Evolution of Physician-Centric Business Models Under Patient Protection and Affordable Care Act by Tanya Nix MBA, Walden University, 2011 BSB, University of Phoenix, 2007 Doctoral Study Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Business Administration Walden University September 2014 Abstract For several decades, the cost of medical care in the United States has increased exponentially. Congress enacted the Patient Protection and Affordable Care Act (PPACA) of 2010 to ensure affordable healthcare to the citizens of the United States. The purpose of this case study was to explore physicians’ perspectives regarding physiciancentric business models evolving under the requirements of PPACA legislation. Complex adaptive systems formed the conceptual framework for this study. Data were gathered through face-to-face, semistructured interviews and e-mail questionnaires with a purposeful sample of 20 participants across 14 medical specialties within Northeast Texas. Participant perceptions were elicited regarding opinions of PPACA legislation and the viability of business models under the PPACA. In addition, a word cloud was used to identify 3 prevalent or universal themes that emerged from participant interviews and questionnaires, including (a) use of mid-level practitioners, (b) changes to provider practices, and (c) lack of business education. The implications for positive social change include the potential to develop innovative models for the delivery of medical care that will improve the health of the aggregate population. Healthcare leaders may use the findings to advance the evolution of physician business models that meet the needs of healthcare stakeholders. These findings may also inform healthcare leaders of the need to develop cost-effective and innovative organizational models that are distinct to individual patient populations.For several decades, the cost of medical care in the United States has increased exponentially. Congress enacted the Patient Protection and Affordable Care Act (PPACA) of 2010 to ensure affordable healthcare to the citizens of the United States. The purpose of this case study was to explore physicians’ perspectives regarding physiciancentric business models evolving under the requirements of PPACA legislation. Complex adaptive systems formed the conceptual framework for this study. Data were gathered through face-to-face, semistructured interviews and e-mail questionnaires with a purposeful sample of 20 participants across 14 medical specialties within Northeast Texas. Participant perceptions were elicited regarding opinions of PPACA legislation and the viability of business models under the PPACA. In addition, a word cloud was used to identify 3 prevalent or universal themes that emerged from participant interviews and questionnaires, including (a) use of mid-level practitioners, (b) changes to provider practices, and (c) lack of business education. The implications for positive social change include the potential to develop innovative models for the delivery of medical care that will improve the health of the aggregate population. Healthcare leaders may use the findings to advance the evolution of physician business models that meet the needs of healthcare stakeholders. These findings may also inform healthcare leaders of the need to develop cost-effective and innovative organizational models that are distinct to individual patient populations. Evolution of Physician-Centric Business Models Under Patient Protection and Affordable Care Act by Tanya Nix MBA, Walden University, 2011 BSB, University of Phoenix, 2007 Doctoral Study Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Business Administration Walden University September 2014 Dedication I would like to dedicate this doctoral study to my husband. You have been my rock throughout this journey and I cannot thank you enough for your support, understanding, encouragement, and the many times you read, edited, and reread this dissertation! Acknowledgments I would like to thank my committee members, Dr. Lynn Szostek, Dr. Kenneth Gossett, and Dr. Robert Hockin, as well as Dr. Reginald Taylor for working with me to ensure that this study met the academic standards of Walden University. I am grateful to Dr. Lynn Szostek for working as my committee chair. Throughout this process, Dr. Szostek has been a source for guidance, support, and encouragement. I would also like to specifically thank Dr. Kenneth Gossett for his contributions to the success of this project and Dr. Reginald Taylor for his recommendations and guidance. It has been my honor and privilege to work with all of you during this journey.