Healthcare Staffing Report: Oct. 3, 2013

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Survey finds changing landscape for locum tenens

Staffing Industry Analysts recently concluded its semiannual benchmarking survey administered in conjunction with the National Association of Locum Tenens Organizations. The results provide some notable takeaways regarding divergent growth trends among the various specialties within the locum tenens market.

Though still two of the most highly compensated physician specialties, each earning more than $300,000 per year on average, according to Medscape, radiology and anesthesiology are fields in decline. Once the two largest occupations within locum tenens, they combined to account for just 8 percent of revenue in the first half of 2013.

Click on chart below to enlarge.

Radiology has been suffering a multi-year contraction, as imaging technologies pioneered in the 1980s such as MRI and CT scanning have matured and become more price sensitive, while the emergence of teleradiology has evened out demand by enabling images to be read by a physician on the other side of the country, or the globe. It seems the dominant constraint, however, has been a spate of Medicare payment cuts, including reimbursement caps and multiple procedure reimbursement reductions. According to the American College of Radiology, the field has endured a dozen separate cuts since 2006, with a combined impact of roughly $6 billion. Total radiology staffing revenue among respondents in the period fell 19 percent compared to the first half of 2012, driven by a 21 percent drop in days billed.

Anesthesiology felt the most pain, ironically, as revenue in the specialty declined 22 percent in the first half of the year from the same period in 2012. Stronger pricing helped ease what would have been an even greater contraction, however, as the 29 percent plunge in days billed was partially offset by a 10 percent increase in bill rate. Much like radiology, anesthesiology has been the target of a number of reimbursement cuts in recent years, which has led to a wave of consolidation of anesthesiology practices across the country. The specialty has also faced burgeoning encroachment by certified registered nurse anesthetists (CRNAs), who are able to provide many of the same functions but cost one-sixth as much to train and command half the salary. According to our recent survey on the allied and advanced practice markets, CRNA staffing revenue was up 16 percent year-over-year through the first half of 2013.

On the flip side of the locum coin, emergency medicine and hospitalist staffing revenue grew 19 percent and 16 percent, respectively, from the first half of 2012 to the first half of 2013. Those two occupations are now the largest in locum, combining to constitute nearly half of the revenue accounted for by the survey. Though the smallest in market size, urgent care exhibited the strongest growth, expanding revenue by one-third over the measured period.

The full NALTO-Staffing Industry Analysts benchmarking report is available only to those companies that participated in the survey. For more information on NALTO, click here.

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