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Why Clinical Integration is Essential for the Future of Independent Physicians

by admin on April 14, 2014 No comments

med networkBy: Ben Humphrey, MD, CPE, MGO Healthcare Consulting – Guest Contributor

We’re past the tipping point and are proceeding headlong into new market-driven accountability for quality, cost and value.  As these large-scale changes progress, physicians who want to thrive and be positioned for long-term success will have to embrace new ideas and approaches in their practices.

A few years ago physicians in Ohio created their own physician-owned company to assist themselves with success in the changing world of healthcare.  Via their company, The Medical Group of Ohio (MGO), they created a clinically integrated physician network comprised of nearly 2,100 physicians.  The vast majority of these physicians are in small independent practices.  Being clinically integrated means the physicians are working together, using proven physician-created protocols and measures, to demonstrably improve patient care, decrease cost, and deliver value.

At the heart of medicine is the patient-physician relationship.  As physicians we view this as the basis for good health and healthcare delivery.  Individually we are providing excellent, yet uncoordinated care.  This new approach has allowed MGO to advance a clinically integrated network of physicians and facilities by having the knowledge, tools and confidence that our patients will be receiving the best, most appropriate care possible.  That care is coordinated throughout the entire continuum of care.  Accordingly MGO has been able to directly and demonstrably affect health outcomes for large populations of patients while also being able to bend the cost curve which is so desperately needed and being demanded in the marketplace.

By their collective efforts MGO physicians have been able to invest in the resources needed to build and enable this network.  The cornerstone is proprietary data collection and software that has allowed us to have access to the most complete and trusted patient data offered.  MGO has effectively utilized this data to measure the performance of the individual physicians/groups and the network as a whole, rewarded performance, and continuously shared best practices enabling improvement through practice transformation.  Simply, MGO has enabled physicians by providing actionable information regarding their patients in a real time fashion.

MGO is a physician-owned and led organization; hence the approach is physician-driven.  Physicians are not only “at the table” but are collectively creating and implementing the clinically integrated / accountable care approach.

This approach is having great success in our market and physicians have been rewarded appropriately for their success.  To deliver this clinically integrated program has necessitated MGO to collectively negotiate reimbursement rates on behalf of the entire physician network.

Many ask if this type of model is applicable within their own market.  The answer is yes.  MGO has shared its approach with physicians throughout the country and as a result local, physician-led clinically integrated approaches are developing,

While this approach involves significant change; it is absolutely necessary.  As employers and/or payers demand proven value-based healthcare and with the inevitable shift from rewarding volume to rewarding value; physicians must be able to demonstrate a new standard of care to effectively remain competitive for the foreseeable future.

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Additional information about MGO’s clinically integrated network can be found at www.TheMGO.com and www.Health4.com.

Dr. Ben Humphrey served for nearly 20 years as The Medical Group of Ohio’s CEO- from the company’s inception. He is currently working with MGO Healthcare Consulting. MGO is Ohio’s largest Independent Physician Association (IPA) and along with its hospital partner, OhioHealth, has created a successful clinically integrated network of physicians and facilities called Health4.  Health4 has network contracts with the market’s large commercial payers and Medicare advantage plans.

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