Physicians associated with Saint Mary’s Health Care are planning a new organization intended to more closely link independent doctors and Advantage Health’s roster of primary care doctors.
The organization, currently with the working title of Clinical Integration Organization, eventually could encompass a total of about 240 doctors who would be connected by factors such as patient care standards, common insurance carriers and computer systems, said Dr. Paul Farr, who is chairing the board of the new group.
Shifts in health care — impending reform in Lansing and Washington, the emphasis on patient-centered practice models and the prospect of bundled Medicare payments that could be tied to quality outcomes — have set the doctors on this course, Farr said.
“We’re pretty excited,” he said.
He said that the group of doctors, with encouragement from Saint Mary’s President & CEO Phil McCorkle, started work on the CIO about 18 months ago. He said the goal is to create a patient experience that is similar to that of the well-known Mayo Clinic in Minnesota, but giving physicians an option of whether to accept hospital employment or retain an independent practice. The Mayo Clinic employs its doctors.
The board of directors includes: Dr. Terry Wright, vice chair of the board, who heads the membership committee; Advantage Health CEO Dr. David Blair as chief medical officer; and Drs. Emily Gualtieri, Neil Colegrove, Connie Leahy, Jay LaBine and Tom Foster. Two additional board members are yet to be named, according to a letter sent to the Saint Mary’s medical staff last week.
“When you look at care-delivery models like the Mayo Clinic, they’re so well-organized. Everyone is on the same page,” said Farr, a gastroenterologist who is former president of the Michigan State Medical Society.
“The patient experience is really a good one. Why can’t we do that here?”
Advantage Health, which employs about 120 primary care physicians, is partly owned by Saint Mary’s and will be a CIO member. Blair, who is profiled on page 8, said the intent is to organize a medical services organization that would sell Advantage Health’s management services.
“We’re going to assemble an MSO — Medical Service Organization — underneath it, which will then sell services to alliance physicians: medical management, contracting, human resources, finance, credentialing, recruitment,” Blair said.
“Advantage has had contracted relationships with 17 different groups in town which were either primary care or specialty groups. We work together mostly on medical management and contracting, but we are looking at creating a much richer set of services.”
Farr said one of the basic steps in improving the patient experience will be to make sure all the members and Saint Mary’s accept the same insurance products. Like some other physicians organizations, the CIO would handle negotiating those contracts for its member doctors, Blair said.
Blue Cross Blue Shield of Michigan and Priority Health — the two major health care plans in the area — are sure to be on the list, Farr added.
“We haven’t finalized that. That’s something that will really be essential,” he said. “Some are wonderful partners, others are tough partners. We’re willing to work with anybody who is willing.”
He said the number of patients being treated by CIO members and the hospital should provide better footing for negotiating with payers.
BCBSM and the Spectrum Health-owned Priority Health have both offered altered reimbursement programs for doctors who install the patient-centered medical home approach in their practices. The model is intended to be a more holistic, collaborative approach by care providers and leverages information technology for tracking standards of care for patients with chronic diseases in an attempt to keep them out of hospitals.
BCBSM recently informed Advantage Health that all of its locations have met its criteria for certification under its patient-centered medical home program, said Blair, who has been an advocate for the model.