“America’s doctors are facing an epidemic.” That’s the headline on the Association of Independent Physicians’ website. Their statistics confirm this: In 2000, well over half (57 percent) of all physicians in the United States worked for themselves. Now, that number (36 percent) is closer to one in three.
To halt this trend, six of the largest independent medical groups in the northern half of Ohio recently joined forces to form the Ohio Independent Collaborative (OIC). By doing so, they are not only preserving their independence but also offering patients easier access to care, lower costs, higher clinical quality and better overall care, according to Gary Pinta, MD, OIC President.
“We believe that independent physicians, meaning physicians not employed by a hospital or corporate health care, deliver a particular brand of care which needs to be preserved and protected,” says Dr. Pinta. “That brand of care has a respect for the sanctity of the long-term individualized physician/patient relationship, which is special. The physicians know their patients and their particular wants and needs, and the patients know and trust their physicians. And this results in higher quality of care.”
“We believe that independent physicians … deliver a particular brand of care which needs to be preserved and protected.”
— Gary Pinta, MD, President of the Ohio Independent Collaborative
Jennifer Hohman, MD, agrees. Her group practice, Northern Ohio Medical Specialists (NOMS), is an OIC member.
“I think the independent physician continues to view medicine as more of a calling, following their passion to really make a difference in the lives of patients,” she says. “In an employed setting, the business of medicine can sometimes get in the way of the close doctor/patient relationship.”
Robert Kent, DO, FACI, Chair of OIC, points out , “A lot of health systems do an excellent job, but sometimes they’re allocating patients. By creating and building strong relationships with independent medical groups, we’re able to strengthen the local medical landscape and allow patients to continue to receive great care at the same hometown offices and with the same hometown physicians they’ve relied on, sometimes for generations.”
Currently, the OIC is comprised of more than 800 physicians in primary care and 40 different specialty areas, including cardiology, general surgery, hematology/oncology, neurology, orthopedics, pathology, radiology, urology and more. The six member groups, all of which have retained their medical practice names and independence, include:
- Central Ohio Primary Care. With more than 300 providers and 55 practice locations throughout central Ohio, COPC is reportedly the largest physician-owned primary care medical group in the U.S.
- Northern Ohio Medical Specialists Healthcare. This multispecialty physician group includes about 90 providers in offices in Bellevue, Clyde, Fremont, Huron, Norwalk, Oberlin, Port Clinton, Sandusky, Sheffield, Tiffin and Willard.
- Pioneer Physicians Network. Pioneer includes 32 board-certified primary care physicians with specialties in family practice, pediatrics and internal medicine, who provide care at 11 locations throughout the Greater Akron/Canton area.
- Premier Physicians. Located in Westlake, this multi-specialty physician group includes 103 providers and offers family and internal medicine services, 25 medical and surgical specialties, along with diagnostic lab services and rehab therapies.
- The Toledo Clinic. This multispecialty group includes 165 physicians in primary care and more than 35 specialty areas at 70 office locations in Ohio and Michigan. It records over 1 million patient visits a year.
- Unity Health Network. Unity offers primary care and specialty care in 15 different areas with 117 providers at 31 locations in five Northeast Ohio counties, including Summit, Stark, Medina, Portage and Cuyahoga.
“OIC has a very large primary care component,” says Dr. Pinta. “Unity has both PCPs and specialists, and so does NOMS, Premier and The Toledo Clinic. Pioneer is all primary care. Central Ohio Primary Care is 95 percent primary care.”
“The Ohio Independent Collaborative offers a great opportunity across the state … to change the dynamics of healthcare in a dramatic fashion.”
— Robert Kent, DO, Chair of the Ohio Independent Collaborative
All together, the six groups provide care to more than 900,000 patients. That’s one of every 17 patients in the state of Ohio. And that, according to Dr. Kent, is what makes the OIC unique.
“Our collective patient population gives us the breadth of the data needed to make sure we’re doing things as efficiently as possible and as clinically appropriate as possible to ensure we give each patient the best care at the most affordable prices,” he says. “We’re sharing resources and data to be more effective and more efficient, so our quality outcomes are better. The OIC offers a great opportunity across the state to do this — and to change the dynamics of healthcare in a dramatic fashion.”
Improving Care and Economies
Every OIC group uses the same cloud-based electronic health record (EHR) system. And this makes it easy, according to Dr. Hohman, to gather data from each group and evaluate it to improve population health, establish quality metrics and identify cost saving measures.
“We’ve already started working with our software vendor to focus on projects that will allow us to improve both the delivery and quality of patient care,” says Dr. Hohman. “With all members using the same EHR, data mining becomes a real possibility, giving us the ability to identify ways to lower costs and increase savings — for patients and physicians alike.”
“There are other very viable options for a thriving practice in addition to hospital employed arrangements.”
— Jennifer Hohman, MD, member of the Ohio Independent Collaborative
For example, data mining will be used to identify individual patients who make frequent trips to hospital emergency departments for conditions which could be resolved more appropriately and more cost-effectively in their primary care physician’s office.
“Maybe these patients just need extra care from their PCP to stay out of the ER,” says Dr. Pinta. “So we’ll be able to use data better together as a collaborative than we could individually, to identify those patients and best practices in other situations. And from that standpoint, I believe quality will improve.”
Data mining will also be used to identify best business practices, for example, in group members’ call centers and billing departments.
“What we’re bringing to the table to develop are the best methods and ideas of doctors from across the state, and then using these as resources to help each other,” Dr. Kent explains. “For example, we’re sharing data on how to best take care of patients from the time they call for an appointment to the time they’re in our office for an exam to the time they go to rehab. And I think the impact on outcomes will be remarkable.”
Reducing Costs, Increasing Revenues
The opportunity to participate in group purchasing is one of the economic benefits of joining the OIC. Currently, negotiations are underway with suppliers of medical and office equipment and supplies to reduce costs. An OIC subcommittee is also considering a captive medical malpractice insurance company to reduce insurance premiums. And soon, the OIC will announce an exclusive Medicare shared savings contract with a large national insurer.
“The Medicare contract is something that could not have been accomplished by my group [Pioneer] alone,” says Dr. Pinta.
Dr. Hohman can relate wholeheartedly to that. Her practice includes just one other family physician.
“About six years ago, my partner and I joined NOMS because of the efficiencies of a larger group — efficiencies like information technology, human resources and those types of administrative services — and also for the economies of scale,” she explains. “So, going from a two-physician practice to a multi-specialty group practice, we had already seen what works. Joining the OIC makes sense on an even larger scale.”
Dr. Kent says they’re only beginning to explore the benefits created by the OIC. But he admits that the results are already outstanding for everyone involved.
“Through this massive collaboration, we’re able to work together with one voice,” he says, “and it’s making a huge, huge impact on health care across the state.”
Planning for the Future
As for future endeavors, the OIC’s to-do list is long. It includes further development of their population health plan strategy, the addition of third-party payor contracts that support this strategy, expansion of their technological infrastructure, and partnerships with select hospitals for inpatient care. Logically, expansion of the OIC’s membership is also on the list.
All three doctors say they never expected the growth they’ve had since news about the OIC was released last August. They are admittedly astonished and overwhelmed by the enthusiasm of each physician group they meet.
“We all want the same thing — independence,” says Dr. Pinta. “The physicians who are independent are independent for a reason, not by chance. It’s really a choice to continue to practice in a way that we feel best benefits the patient.”
“I think it’s important for physicians to know that there are other very viable options for a thriving practice in addition to hospital employed arrangements,” adds Dr. Hohman.
Dr. Kent agrees. “With this model, there’s still hope for independent practices to exist and succeed.”