Physicians own fewer and fewer practices while hospitals are taking them over at a rapid clip, according to six years of survey data from the Medical Group Management Association (MGMA). You can see how these two trends appear to correlate in this chart, courtesy of the MGMA. We're running our own Part B News survey on this same topic, which I'd love for you to take (it's just a five-minute survey). The real question: Are your physicians thinking about merging with local groups or selling out to a hospital?

The House Ways and Means Committee posted the text of The American Jobs and Closing Tax Loopholes Act of 2010 (HR 4213), along with summary documents. Here's my read of the bill's Medicare payment provisions:

• 1.3% increase to Medicare reimbursements from June 1 through Dec. 31.
• 1% increase to Medicare payments from Jan. 1, 2011 through Dec. 31, 2011.
• Physician reimbursement rates will not drop during 2012 and 2013. Payments could go up to keep up with spending growth.
• Medicare reimbursements would be subject to sustainable growth rate (SGR) cuts in years 2014 and beyond.
• Physician practices in California would see higher payments because of updates to the geographic adjustment factor, or GAF. Physicians have protested payment imbalances in the Golden State over the last several years.

Congressional Democrats released a summary of "The American Jobs and Closing Tax Loopholes Act of 2010" (H.R. 4213), which would delay the sustainable growth rate (SGR) cut to Medicare payments for the next several years.

Here's what it says about the SGR and physician pay:

Medicare physician payment rates are scheduled to be reduced by more than 20 percent in June. This provision would provide reasonable updates in physician payment rates for the rest of this year and next year. For 2012 and 2013, rates would continue to increase if spending growth on physician services is within reasonable limits, with an extra allowance for primary and preventive care. Rates could not be reduced in 2012 or 2013, but after that rates would return to their current law levels. This provision is being estimated by the Congressional Budget Office.

Leaders in the House and Senate are drafting a four-year Medicare physician payment plan that would raise reimbursements by 2.2% for the rest of 2010, provide a 1% increase in 2011 and potentially institute additional positive updates through 2014, according to an analysis by the AMA.

However, the AMA and other groups are mounting opposition to the plan. This approach temporarily delays the sustainable growth rate (SGR) cut until 2015 -- when physician reimbursements would drop 37%, according to estimates.

"By 2015, we believe that the price tag to permanently repeal the SGR, or even extend the proposed 2012-2014 policy, could exceed $500 billion," the AMA says.

A sixth of general internal medicine physicians leave their practices by mid-career, a rate four times that of subspecialists in internal medicine, a new survey shows. The survey, released May 7, was conducted by the American College of Physicians (ACP) and the American Board of Internal Medicine (ABIM). "The research results underscore the importance of increasing the attractiveness of careers in general internal medicine and of retaining those who enter the field," said Wayne Bylsma, vice president and chief of staff for the ACP, and one of the study's lead authors.