JAMA Study Reaffirms Independent Medical Setting is Most Cost Effective

Washington, D.C. – The Journal of the American Medical Association (JAMA) published findings from independent researchers at the University of California at Berkeley which added to the body of data demonstrating that the independent practice of medicine is the most cost-effective site of service for the delivery of health care.

The study reviewed total costs of care for approximately 4.5 million patients from 2009 to 2012 and found that spending per patient was 10.3 percent higher for hospital-owned physician offices than compared with doctor-owned organizations. The costs were nearly 20 percent higher when hospital networks employed physicians than when independent physician offices provided care.   

The JAMA study is consistent with a recent GAO report on radiation therapy, which found that after 2007 there was a substantial migration of prostate cancer patients from hospitals to physicians’ offices where these services about are about 10 percent less costly.  As a result, despite increased volume of services, prostate cancer-related radiation costs in physicians’ offices decreased by $28 million; simultaneously hospital prostate radiation expenditures increased by $8 million even though the number of services declined at this site of service.

Unfortunately, despite independent research confirming that physicians in integrated group practices provide high-quality, affordable health care, specialists with historical monopolies on the delivery of certain health care services are asking Congress to eliminate the rights of patients to seek care at the site of service of their own choosing. This self-serving policy fix would only restrict access to care and drive up costs.

“The data supporting the cost-effectiveness of the independent, integrated model of care continues to mount,” said Dr. Juan Reyna, president of LUGPA.  “The future of health care is not a return to the silo-based care models of the past.  There are always going to be outliers –established investigative and regulatory mechanisms can handle such isolated instances.  The physicians’ office provides an important competitive counterbalance to health care monopolies – this free market solution should be not only be preserved, but nurtured.”


  LUGPA represents urology group practices in the United States, with more than 2,200 physicians who make up more than 25 percent of the nation’s practicing urologists. LUGPA and its member practices are committed to best practices, research, data collection and benchmarking to promote quality clinical outcomes. For more information, visit lugpa.org