Hospitalist workforce grew steadily from 2012 to 2019
Hospitalists are now one of the top five largest physician specialties in the U.S., according to an analysis of Medicare Part B claim coding patterns. However, relatively few physicians self-identified as hospitalists in Medicare's Provider Enrollment Chain and Ownership System.
The number of physicians practicing adult hospital medicine grew 50% in 2012 to 2019, and totaled 44,037 by 2019 when measured by percentage of billing, a study found.
The retrospective study used national Medicare Part B claims datasets and categorized physicians as hospitalists if at least 90% of the Healthcare Common Procedure Coding System codes for their National Provider Identifier were for codes commonly associated with hospitalist billing. The study also analyzed how many physicians selected hospitalist as their specialty designation in Medicare's Provider Enrollment Chain and Ownership System (PECOS). Results were published by the Journal of Hospital Medicine on Aug. 30.
The study found that on average, the number of hospitalists grew by 2,228 each year from 2012 to 2019. In 2019, there were 44,037 adult hospitalists, according to the 90% threshold method of calculation. However, only 12,059 hospitalists had self-identified in the PECOS database, leading the study authors to conclude that the 90% billing threshold, although imperfect, “may be the best available tool given that few hospitalists have self-identified using the PECOS C6 modifier.”
Based on the results, hospitalists are in the top five largest physician specialties in the United States, comparable in size to emergency medicine, they noted. “Our findings on the growth of hospitalists are particularly striking as, concurrently, the number of total hospital beds per 1000 population in the United States declined from 3.0 in 1999 to 2.4 in 2019,” the authors said. Possible explanations include a continued shift of inpatient care from primary care physicians to hospitalists, lower patient loads per hospitalist, and increasing time spent by hospitalists on nonclinical work.
“As hospitalists are a large constituency in the healthcare system, accurate identification should be a priority for healthcare decision-makers at all levels,” the study authors concluded.