Possible, but they will have to downsize like crazy. For the healthcare business, all the volume is in Medicare folks.
But, if you don’t have a margin, you can make a profit with more volume. We are very close to the tipping point. Hospitals will get the money, while providers in small groups and solo practices will not find Medicare patients profitable. Moreover, the regulatory environment will increasingly subject small providers to criminal penalties. This will leave doctors in hospital groups as the main providers for Medicare. Right now, hospital employed physicians comprise about 55% of the total, so a loss of 20-30% of non hospital physicians would be large and lead to severe access problems. Downsizing is not necessarily an unprofitable proposition, and this option will be attractive for physicians within 5-10 years of retirement or younger physicians that don’t like government medicine and aren’t afraid to set up small, nimble boutique private practices (but not in MA).