How do you see expanding your vision into these other markets that are quite different from the northern New Jersey healthcare market?
We have very good corporate talent here as Summit Health Management. And there’s good management talent in Bend and in Phoenix, on the medical management side. And we’re looking at best practices, in order to reach the Quadruple Aim—high quality, low cost, great patient experience, and high provider engagement. And we bring management skill and capital, and we bring maturity in governance and leadership, to be able to commit to a way of integrated healthcare practice.
One metric I love to talk about is that we’ve grown from 125 to 800 providers in the past six years, with less than 1 percent turnover. So having that dual ownership and management of the groups—we all have the same vision going forward.
How did you end up in these particular markets?
Our relationship with the physician group in Bend came from an investment bank, where we looked at their book of business. With regard to the group in Phoenix, we had met their senior leaders at conferences and meetings, and we ended up initiating a dialogue, and found what their constraints were as a loosely organized IPA [independent practice association] that has an overarching management company that offered contracts. And we started to speak with them, because they needed some capital, and the cultures of these groups were similar to ours. And that started a dialogue about moving in this direction.
Both groups are operating in markets in which there are progressive health plans whose senior executives have expressed the desire to collaborate further with providers. Do you see a fair amount of potential there?
Absolutely. In New Jersey, we have one of the most advanced commercial risk products, and we understand Medicare Advantage, and we understand NextGen [the NextGeneration accountable care organization program under the Medicare program]. And we feel there’s great opportunity to bring great quality at lower cost, with great patient satisfaction, and physician engagement.
And so you see great potential for partnerships with progressive health plans, in both markets?
Yes, I do.
How are you going to address physician social insecurity in the face of policy and payment changes? In other words, how are you addressing physician culture issues and challenges?
That’s number one for us. We would not have spoken to the physicians in either Phoenix or Bend, had they had not had a culture similar to ours. That was of utmost priority to us. If they didn’t have a similar culture of putting patients first, in the group practice context, we wouldn’t want to talk to them.
So you and your colleagues did your cultural due diligence, then, correct?
Yes, absolutely, that was first and foremost. I joke about this, but it’s like getting married! You really have to do your due diligence, and see what their culture is, whether it’s similar to yours or not. If not, it’s not worth it, because they wouldn’t have the same type of belief system, and that would make it impossible to move forward in the way we would want.
It seems as though this is a time of opportunity for physician group leaders with vision and who know what they’re doing, as policy and payment trends shift?
I have to say this, and it’s not rocket science, and I don’t want to sound arrogant. But if you develop a business model—we grow our primary care attribution, work closely with specialists—if you manage all transitions of care, and use the hospital as a center for tertiary and quaternary care, but keep 95 percent of care on the ambulatory side—that’s a recipe for success.
What should CIOs and CMIOs at hospital-based health systems be thinking about these developments?
Health systems always look at us as something of a threat; they think we’re trying to cull their network. That’s not the case. We view hospitals in a neutral way, even as we’re focused on the ambulatory side. We feel we can grow a network and take care of the patients on the ambulatory side, while finding ways to partner with hospitals on the inpatient side. We don’t look at hospitals as threats, and we never have. We look at hospitals as partners in performing good patient care, as we move patients as much as possible onto the ambulatory side. There is a good way to do this and to improve quality, collaboratively.
Meanwhile, at some point in the future, you’ll be expanding your operations further?
Yes. We are out in the market now, looking at opportunities in various markets.
Get the latest information on Health IT and attend other valuable sessions at this two-day Summit providing healthcare leaders with educational content, insightful debate and dialogue on the future of healthcare and technology.