The pending $50 million sale of Physician Associates, Central Florida's largest medical practice, to Orlando Health marks a giant shift in the local health-care landscape.

When the expected merger takes effect Dec. 31, each of the group's 95 physicians will receive about $500,000, said Dennis Buhring, practice administrator of Physician Associates.

At that moment, all the physicians will go from being independent practitioners to hospital employees.

And that's what has some critics worried.

"This will have a huge ripple effect of unintended consequences," said Tommy Thomas, a Winter Park accountant who represents 110 physician groups. "If you want to bankrupt the health-care system, employ all the physicians."

Physician Associates dominates the local primary-care market. Collectively its physicians, who are part of the 28-year-old practice of mostly primary-care doctors, care for about 340,000 patients. The next-largest practice in Central Florida has fewer than 10 doctors.

Both the physician group and Orlando Health a nonprofit, multihospital system that owns Orlando Regional Medical Center and eight other local hospitals think the move is essential given the direction health care is going.

"Our goal is to move to a new payment model and reduce the costs of health care," said Dr. Wayne Jenkins, who directs Orlando Health Physician Partners, the 400 physicians already employed by Orlando Health. "If we drive up health-care costs, we will find ourselves in a losing position."

However, critics, including Thomas, say such acquisitions, which are becoming more common across the nation, increase costs without adding value. A common ploy is for the hospital to layer in a facility fee on top of the doctor's fee even when patients are going to the same doctor's office.

The mergers also can reduce access because providers may feel obliged or be required to refer patients exclusively to the hospital that employs them, experts say. Some staff members in these practices may lose their jobs as hospitals take over office management.

Follow this link:

$50M sale of Physician Associates signals major shift in Orlando health care