Physicians: Tenet Healthcare wants you
By Andrew L. Wang, Crain’s Chicago Business
Posted: February 6, 2014 – 12:15 pm ET
About seven months after it was acquired by Tenet Healthcare Corp., the Chicago-area physicians group that provided care at four former Vanguard Health Systems hospitals is pushing to double its size in the coming year.
Chicago Health System, which has 1,000 physicians in its fold, including about 100 employed doctors, was among the properties swept up by Tenet in October when the Dallas hospital giant purchased Nashville-based Vanguard and its 28 hospitals in a deal valued at $4.3 billion. Vanguard’s local hospitals—Weiss Memorial in Chicago, Westlake in Melrose Park, Ill., West Suburban Medical Center in Oak Park, Ill., and MacNeal in Berwyn, Ill.—were also part of the transaction, which brought Tenet’s total to 77.
Now, Chicago Health wants to increase its headcount, between affiliated and employed doctors, to 2,000, and bring its number of employed physicians to 170, CEO Patrick Sorrentino said.
In its pitch to doctors, the network says it will let independent practices maintain their autonomy, while providing back-office support and IT infrastructure that most small practices wouldn’t be able to afford on their own. Further, affiliation would potentially offer them access to more patients and higher reimbursement rates through Tenet’s national insurance contracts, which would include quality-based incentives like those found in accountable care organizations, or ACOs.
“The aggregation of a large group of providers is stronger than individual units,” Mr. Sorrentino said. “We want to be able to put a group together to withstand the changes that health reform is bringing.”
The recruitment push comes at a moment when the economics of medical practices are under pressure, leaving independent doctors looking to sell out to bigger groups or to hospitals. The fixed costs of a practice—rent, malpractice insurance, technology investments—gobble up a sizable chunk of revenue before a single patient walks in the door, and small-fry practices have little clout with insurance carriers to negotiate higher payments.
Plus, with government and private payers shifting to ACO-type payment contracts that reward doctors for good health outcomes rather than high volume, independents risk missing the boat on those quality-based payments, one expert said.
“It’s not just being able to bill at a higher rate—it’s things like clinical integration that a lot of payers are willing to pay for, that you can’t do alone,” said Dr. Joel Shalowitz, director of the health industry management program at Northwestern University’s Kellogg School of Management.
HOSPITALS GAIN, TOO
Of course, Tenet and other hospital operators benefit from affiliating with or acquiring doctor practices. Demand for inpatient care is sinking, and hospitals want to steer patients in need of outpatient and ancillary services such as diagnostics and imaging to places where they can capture the revenue, Dr. Shalowitz said. Hospitals also can gain more control over quality and outcomes.
athenahealth Selected by Medical Professional Services, Inc. to Manage Population Health Across Its Care Network
WATERTOWN, Mass., Jan. 21, 2014 (GLOBE NEWSWIRE) — athenahealth, Inc. (ATHN), a leading provider of cloud-based services for electronic health record (EHR), practice management, and care coordination, today announced that Medical Professional Services, Inc. (MPS) will use athenahealth’s cloud-based Population Health Management offering to improve care quality and coordination across MPS’ growing network of providers and patients, in both fee-for-service and risk-based payment scenarios.
MPS, founded in 1986, is one of Connecticut’s largest multi-specialty Independent Physician Associations (IPA), with over 450 physician and mid-level providers, including primary care physicians, medical and surgical specialists, and hospital-based physicians. By partnering with athenahealth, MPS will gain needed access to important clinical and financial information that has historically lived in disparate health information systems. This information will enable MPS to better understand patient activity and proactively coordinate care across its network. MPS will also gain the unique ability to harmonize clinical, financial, and operational data, which will empower the MPS physician leadership and care coordination teams to guide actions that directly align with revenue and quality goals.
Drew Edwards, MD, Chief Medical Officer, MPS, said, “Working with athenahealth will enable us to develop the information and analytics we need to help MPS physicians deliver the best, most appropriate patient care in the most cost effective way. The insight and capabilities we will derive from this partnership will also directly support our ACO efforts as part of the Medicare Shared Savings program, as well as help to advance our work with multiple commercial insurers surrounding population health management through shared savings contracts.”
MPS’ subsidiary, MPS ACO Physicians LLC, was selected as an Accountable Care Organization (ACO) to participate in the Medicare Shared Savings Program effective July 2012. Further expanding its work with value-based reimbursement models, MPS is also developing shared-savings health contracts with large insurers, including Anthem, Aetna, Cigna, and others, that will cover tens of thousands of patients across Connecticut.
Doug Arnold, Chief Executive Officer, MPS, said, “Transitioning to value-based reimbursement models is a complex process. To achieve such advanced care coordination, it was clear that we needed a population health management tool to integrate data across different systems successfully, as well as an expert partner on value-based contracts. With athenahealth’s Population Health Management service, we will gain an understanding of where our care services are being delivered and insight into the health of large populations of MPS physicians’ patients. This is an exciting time in health care delivery, where care teams, technology, and incentives align.”
Todd Rothenhaus, MD, Chief Medical Officer, athenahealth, said, “Health care is rapidly migrating toward new payment models—provider organizations everywhere are going with the option to take on responsibility for the total cost and quality of the population of patients under their care. With athenahealth, MPS can be proactive in accounting for each and every one of their patients, knowing where they go to receive care and any cost associated with that care. What’s more, our Population Health Management service delivers the necessary insight, as part of the clinical workflow, to influence patient activity that most effectively meets clinical quality goals, reduces costs, and improves outcomes.”
athenahealth is a leading provider of cloud-based services for electronic health record (EHR), practice management, and care coordination. athenahealth’s mission is to be caregivers’ most trusted service, helping them do well doing the right thing. For more information, please visit www.athenahealth.com.
About Medical Professional Services, Inc.
Medical Professional Services, Inc. (MPS) is one of Connecticut’s largest multi-specialty Independent Physician Associations (IPAs). MPS has over 450 physician and mid-level providers as members, including primary care, medical and surgical specialists, and hospital-based physicians who are dedicated to providing exceptional medical and surgical care to residents throughout Connecticut. To learn more, visit: http://www.mpsphysicians.com/.
Rush Health Chooses athenahealth’s Cloud-Based Services; Brings Power of the Cloud to the Enterprise
athenahealth’s Best-in-KLAS EHR and Practice Management Services Selected to Provide Nimble and Proven Option for Independent Physicians Across the Rush Health Network
WATERTOWN, Mass., Oct. 23, 2013 (GLOBE NEWSWIRE) — athenahealth, Inc. (ATHN), a leading provider of cloud-based services for electronic health record (EHR), practice management, and care coordination, today announced that Rush Health, a clinically integrated network of physicians and hospitals, has endorsed athenahealth’s EHR and practice management services for its more than 300 affiliated private physician members.
Selected as one of the industry leading solutions after a year-long review process involving multiple vendors, athenahealth will help Rush Health support it’s participating physicians and hospitals in delivering high quality, efficient health care services covering the spectrum of patient care from wellness, prevention and health promotion, to disease management and complex care management.
“We believe the EHR and practice management services from athenahealth will support our goals for true clinical integration, and make things like physicians’ transition to ICD-10 and compliance with Meaningful Use simple for our affiliate network,” said Brent Estes, president and CEO, Rush Health. “When it comes to Health Information Technology (HIT), a one size fits all approach isn’t feasible. athenahealth provides a very nimble, highly renowned set of cloud-based services that our affiliate physicians can operate within and connect with the rest of the Rush Health physician and hospital members. We’re providing our physicians with options that we believe to be the best in HIT services so they can focus on care delivery in a truly integrated and innovative environment.”
athenaClinicals(R), recognized by KLAS as the most usable ambulatory electronic medical record, and athenaCollector(R), athenahealth’s practice management service that is proven to increase speed and ease of medical claims processing and collection, will become available to all Rush Health private physician members. Today, athenaCollector is used to process more than $11 billion in client collections per year. On average, practices using athenaCollector see a 29 percent reduction in their days in accounts receivable and an 8 percent increase in collections*.
“Physician practices and health care enterprises of all sizes, including leaders such as Rush Health, are realizing the value of service-backed, highly nimble, cloud-based solutions that don’t require upfront capital, have a very short onramp to get up and running, and are always improving based on knowledge learned across the network,” said Jonathan Bush, CEO, president and chairman of the board of directors, athenahealth. “We’re thrilled to be able to partner with Rush Health, a frontrunner in care delivery and in leveraging innovation to achieve clinical integration, data sharing, and a level of multi-system care coordination that in every care environment should become standard.”
2/19/2014 09:33 AM
David F. Carr is Editor of InformationWeek Healthcare.
Athenahealth Teams With Doctor-Led ACO
Privia Health will integrate the AthenaHealth EHR with its own technology for tracking the follow-up care essential to ACO success.
Athenahealth is joining with a regional physician practice management and population health management firm, Privia Health, to link their technologies and operations to produce a more effective accountable care organization.
The ACO model, promoted by Medicare as one plank of the Affordable Care Act and also being adopted by commercial insurers, tries to shift financial incentives away from providing more care toward providing better care more efficiently. In the Washington, D.C., region, Privia is both enticing doctors to join a medical practice built for this model, Privia Medical Group, and offering those who choose to remain independent a chance to join its ACO, the Privia Quality Network.
ACOs are designed to take an approach to delivering care that puts as much or more emphasis on follow-up and preventative care as on office visits. The goal is to catch problems earlier and eliminate the need for the most expensive care in hospitals and emergency rooms. Privia has developed its own care management software, which it will integrate with the AthenaClinicals cloud-based electronic health records system. Privia Medical Group, which represents 161 physicians and serves more than 300,000 patients, is standardizing on the Athenahealth EHR.
“A big piece of Athena’s vision, in addition to great practice management, is connecting all the different players in healthcare,” said Jeff Butler, founder and CEO of Privia Health. “We have a piece of the puzzle, and we’re plugging into Athena’s broader platform.” One of the Privia Medical Group practices is already using AthenaClinicals and 22 others are implementing it now, with more to follow in the coming weeks. Other practices that affiliate with the ACO will also get access to the software on favorable terms, Butler said.
Getting everyone on the same EHR is not essential, but it is helpful, Butler said. The specific technical integration Privia is doing with Athenahealth will automate some of the important steps in making sure that follow-up care automatically happens. For example, when a diagnosis of diabetes is recorded in the EHR, that will trigger a series of follow-up actions such as making sure the patient gets needed education materials, an appointment with a nutritionist, and tools for monitoring blood glucose and blood pressure. Privia has defined standard order sets for the follow-up care appropriate to many of the most expensive chronic conditions.
“There have been studies showing that you only retain about 10% of the information the doctor tells you when he’s delivering the diagnosis — you’re busy thinking, ‘Oh, crap, I’ve got diabetes,’ so there has to be follow-up to help you with how you will manage your diet, how you will manage your own care,” Butler said.
Initially, Privia’s leaders thought they might allow even the practices that joined its medical group to use whatever EHR they preferred or already had in place and integrate with them via industry standards, Butler said. “What we found is that the market’s not ready for that; the interoperability does not exist to drive the kind of performance we want to drive.”
Privia Medical Group also provides Athenahealth with an opportunity to show how a practice can be designed from the ground up to take full advantage of its technology, Butler said. “We are architecting a high-performance medical group from the ground up.” Usually, software providers are tasked with adapting to the existing workflows of an existing medical group, whereas Privia wants to reimagine those workflows “to fit a sophisticated, high-performance medical group that focuses on population health, focuses on quality.”
Originally a provider of population health analytics to other institutions, Privia pivoted to more active operational involvement in improving the quality of care as it saw the ACO movement developing. “Independent doctors have to be part of a larger, more sophisticated infrastructure if they’re going to be successful under health reform,” Butler said. “We view ourselves as a strategic partner of the health plans because our incentives are aligned. In the old world, the medical practice really was an adversary of the health plan. But when we do our jobs right and take better care of people, the employer saves money, the health plan does better, and the doctors get rewarded for having those kind of outcomes.”
“We love these guys because they’re disruptive to the medical world,” said Todd Rothenhaus, chief medical officer of Athenahealth. Privia is unique as a “purpose-built medical group” for the ACO era, he said. Also, most ACOs have been established by either hospitals or networks of physicians known as Independent Provider Organizations. Privia is the only one he knows of that’s being built around a single, large practice.
“When we saw what they’re doing for patient engagement, we got really excited,” Rothenhaus added. Although everyone talks about doing more to engage patients in improving the quality of their own care, the quality of those efforts varies widely, he said.
The example Privia sets is interesting to Athenahealth in other ways. The regulatory structure surrounding ACOs is one of the policy issues the company has challenged in Washington as inconsistent with CEO Jonathan Bush’s vision of a healthcare Internet. Bush worries the ACO movement will tend to drive excess consolidation, turning hospitals and the physician practices they are buying up into regional monopolies that are able to provide comprehensive care more effectively than independent physicians. One of Athenahealth’s objections is that the law requires that ACOs be majority owned by physicians, so as a publicly traded company it is precluded from participating in the market.
On the other hand, if enough healthcare organizations follow Privia’s model and Athenahealth can sell to them, that might be all right, too, Rothenhaus said. “Maybe we don’t need legislative change. Maybe we just need groups like Privia to disrupt the status quo.”
Download Healthcare IT in the Obamacare Era, our InformationWeek Healthcare digital issue. Modern technology created the opportunity to restructure the healthcare industry around accountable care organizations, but ACOs also put new demands on IT.
David F. Carr is Editor of InformationWeek Healthcare. He previously led coverage of social business and education technologies and continues to contribute in those areas.