NH Medical Society NH Physician Survey September 11, 2013 UNH Survey Center
Methodology UNH Survey Center conducted a web survey of New • Hampshire physicians for the New Hampshire Medical Society (NHMS). Email invitations were sent to 2,965 NH physicians • on June 11, 2013 NHMS members and non-members • A postcard with a link was sent to physicians without an • email address. 588 physicians completed the survey, a response • rate of 20%.
Demographics • Membership • Field of Medicine 66% members of NHMS 19% internal medicine 14% surgery Gender • 13% family medicine 72% male Practice Size • • Age 14% in solo practice 13% under 40 21% 2 – 4 physicians 21% 40-49 23% 5 – 10 physicians 49% 50-64 13% 11 – 20 physicians 17% 65 and Older 29% more than 20 physicians Practice Type • Party ID • 52% hospital or health system 35% Democrats 21% individual group practice 53% 18% Independents – lean Democrat 15% self-employed. 16% Independent 13% Independent – lean Republican 31% 18% Republican
Summary of Findings Top issues to concentrate NHMS legislative efforts Malpractice issues/tort reform • Improving access to mental health services • Development of a no-fault medical liability system • Political Issues Only two issues seen as important for NHMS to take a position on: Physician engagement in end-of-life care • More regulations on the possession of firearms •
Summary Education and outreach opportunities Providing information on Affordable Care Act and • its provisions Non-member education on medical malpractice • screening panel system Electronic Health Records 4 out 5 physicians use EHRs with majorities • agreeing that it improves patient care and disagreeing that it helps with efficiency. Younger physicians are more likely to agree with • both statements about EHRs.
Medical Policy Issues Quadrant Analysis Plots the importance of NHMS taking a position on an issue with the position of physicians on the same issue. High support and high importance for Low support but high importance for NHMS to take a position NHMS to take a position – Malpractice/tort reform – Medicaid managed care – Mental health services – A no fault medical liability system – Health Information Technology – Medicaid expansion – Scope of practice issues Low support and low importance High support but low importance for NHMS to take a position for NHMS to take a position – Gun violence – Restrictive or selective networks – Improving education – Drug testing healthcare workers – Developing disabilities in education – Addressing health effects of climate – Taxes on alcohol and tobacco change – Other environmental health concerns – Integrating alternative medicine
Support 2 3.5 5 4 Malpractice/tort reform Mental health services No fault medical liability system Medicaid Expansion Medicaid Managed Importance NHMS Position Care Health Information Practice issues with Technology non-physician 3 providers Restrictive or Improving selective networks Addressing gun education violence Taxes on alcohol and tobacco Developmental disabilities Other environmental Drug testing of health concerns healthcare workers Health effects of climate change Integrating alternative medicine 2
Support 2 3.5 5 4 Importance NHMS Position 3 Non-members are more Developmental likely to feel it is very disabilities important that NHMS focuses on addressing developmental disabilities (and other disabilities) in education. 2
Support 2 3.5 5 4 NHMS members are more likely to Malpractice/tort reform strongly support Medicaid Expansion Importance NHMS Position 3 Taxes on alcohol and tobacco 2
Top Three Issues Malpractice issues/tort reform 45% 14% 8% Improving Access to Mental Health Services 14% 17% 16% The development of a no fault medical liability system 9% 22% 8% Medicaid Expansion 10% 12% 11% The use of Health Information Technology 7% 7% 11% Medicaid Managed Care 3% 8% 9% Addressing Scope of Practice Issues With Respect to… 2% 4% 8% Restrictive or selective networks 3% 5% 6% Addressing Gun Violence as a Public Health Issue 3% 4% 5% Taxes on Alcohol or Tobacco 1% 2% 5% Improving the Overall Quality of Primary and Secondary… 2% 2% 3% Addressing Other Environmental Concerns 1% 1% Addressing Developmental Disabilities in Education 1% 1% Random Drug Testing of Healthcare Workers 1% 1% Integrating Alternative Medicine With Traditional… 2% Raising Awareness of Health Effects to Climate Change 2% 0% 20% 40% 60% 80% 100% Most Important Second Third
Political Issues Quadrant Analysis Plots the importance of NHMS taking a position on a particular issue against the position of physicians on the same issue. Low support but high importance for High support and high importance for NHMS to take a position NHMS to take a position – State-based single-payor system in – Physician engagement in end of life care NH – More regulations on the possession of firearms including universal background checks Low support and low importance for High support but low importance for NHMS NHMS to take a position to take a position – Therapeutic cannabis – Empty – Physician assisted suicide – Recreational marijuana – Death penalty – Legalized gambling
Physician Support 2 3.5 5 4 Engagement in end Importance NHMS Taking a Position of life care More gun State-based single regulations payor system in NH Medical Marijuana 2.75 Physician assisted suicide Life in prison Marijuana instead of death decriminalization penalty Legalized gambling 1.5
Affordable Care Act How prepared are you to implement the Affordable Care Act in 2014? 50% 45% 41% 39% 40% 36% 35% 35% 30% 26% 25% 21% 20% 15% 14% 14% 15% 12% 11% 10% 10% 9% 10% 8% 5% 0% Very Prepared Somewhat Not Very Not At All Don't Know Prepared Prepared Prepared Overall Members Non-members
Affordable Care Act Do you have access to all of the information you need to navigate the changing healthcare regulation associated with the Affordable Care Act? 100% 90% 80% 70% 60% 51% 50% 45% 42% 40% 29% 29% 29% 29% 30% 26% 20% 20% 10% 0% Yes No Don't Know Overall Members Non-members
Affordable Care Act Provisions Support/Oppose Regulation of health plans 47% 20% 7% 6% 6% 14% Individual Mandate 43% 23% 8% 13% 6% 7% Medicaid expansion 40% 21% 10% 9% 13% 7% Insurance Marketplace (Exchanges) 30% 30% 14% 6% 5% 15% Sunshine policy 33% 24% 14% 6% 11% 12% ACOs – Accountable Care Organizations 16% 25% 18% 11% 12% 18% Physician value modifier 10% 26% 18% 15% 13% 18% Prevention Fund 16% 15% 13% 3% 3% 50% IPAB – Independent Payment Advisory Board 13% 16% 10% 7% 17% 37% Hospital acquired infection payment policy 10% 18% 16% 22% 12% 22% Physician compare 9% 18% 18% 13% 9% 33% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Strongly Support Somewhat Support Neutral Somewhat Oppose Strongly Oppose Not Familiar With Provision
ACA Provisions – Partisan Differences Blue=Democrats, Red=Republicans Support/Oppose Regulation of health plans 47% 20% 7% 6% 6% 14% Individual Mandate 43% 23% 8% 13% 6% 7% Medicaid expansion 40% 21% 10% 9% 13% 7% Insurance Marketplace (Exchanges) 30% 30% 14% 6% 5% 15% Sunshine policy 33% 24% 14% 6% 11% 12% ACOs – Accountable Care Organizations 16% 25% 18% 11% 12% 18% Physician value modifier 10% 26% 18% 15% 13% 18% Prevention Fund 16% 15% 13% 3% 3% 50% IPAB – Independent Payment Advisory Board 13% 16% 10% 7% 17% 37% Hospital acquired infection payment policy 10% 18% 16% 22% 12% 22% Physician compare 9% 18% 18% 13% 9% 33% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Strongly Support Somewhat Support Neutral Somewhat Oppose Strongly Oppose Not Familiar With Provision
ACA Provisions – Membership Differences Blue=Members, Red=Non-members Support/Oppose Regulation of health plans 47% 20% 7% 6% 6% 14% Individual Mandate 43% 23% 8% 13% 6% 7% Medicaid expansion 40% 21% 10% 9% 13% 7% Insurance Marketplace (Exchanges) 30% 30% 14% 6% 5% 15% Sunshine policy 33% 24% 14% 6% 11% 12% ACOs – Accountable Care Organizations 16% 25% 18% 11% 12% 18% Physician value modifier 10% 26% 18% 15% 13% 18% Prevention Fund 16% 15% 13% 3% 3% 50% IPAB – Independent Payment Advisory Board 13% 16% 10% 7% 17% 37% Hospital acquired infection payment policy 10% 18% 16% 22% 12% 22% Physician compare 9% 18% 18% 13% 9% 33% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Strongly Support Somewhat Support Neutral Somewhat Oppose Strongly Oppose Not Familiar With Provision
Medical Malpractice Screening How familiar are you with New Hampshire’s medical malpractice screening panel system? 50% 45% 44% 45% 39% 40% 35% 30% 25% 24% 24% 24% 25% 19% 18% 20% 16% 14% 15% 10% 7% 5% 0% Very Familiar Somewhat Not Very Not At All Familiar Familiar Familiar Overall Members Non-members
Medical Malpractice Screening Do you support or oppose the current medical malpractice screening panel system? 100% 90% 80% 70% 59% 60% 52% 50% 37% 40% 33% 29% 28% 28% 30% 18% 20% 12% 10% 1% 2% 0% 2% 0% 0% 0% Strongly Somewhat Neutral Somewhat Strongly Support Support Oppose Oppose Overall Members Non-members
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