Dialing Up Physician Networks
Success key No. 3: The medical home
The Memorial Hermann Physician Network is a clinically integrated physician organization composed of more than 3,500 doctors throughout the Houston area. It has contracted with Memorial Hermann Healthcare System to carry out a medical home program involving independent and employed physicians representing a variety of specialties, which led to Memorial Herrmann's receiving its ACO designation in July.
The doctors are not employed by a single entity, but encompass various practices. In addition, only physicians who agree to the medical home concept are brought into the ACO, according to Shawn P. Griffin, MD, chief quality and informatics officer at the Memorial Hermann Physician Network, associated with the 3,514-bed Memorial Hermann Healthcare System.
In effect, under the Memorial Hermann medical home initiative, known as Advanced Primary Care Practices, physicians must practice evidence-based medicine and report their performance on nationally accepted and validated clinical and satisfaction metrics, Griffin says.
Memorial Hermann is selective about the physicians who join the network, but also provides incentives for those who do, Griffin says. "We're a physician-led organization, and when we look at physicians who want to participate we're willing to subsidize some of the practices to get on the [electronic medical records]" for instance, he says.
"The group of doctors will have incentive metrics that they share and organize, and look at quality and finances," he adds. "We'll provide doctors with some reporting tools for them to track how they are doing. We also supplement whatever we can legally provide in their practice to facilitate and track referrals."
Memorial Hermann collects data from its provider network, effectively acting as "our own type of health information exchange," Griffin says. Within a few years, more than 200 medical practices are expected to be involved in medical home programs, he adds. The network will be initially focusing on specific disease types, such as diabetes and colorectal cancer, to improve coordination of patient care.
Primary care physician networks showing greater efficiency may attain better contracts with payers, he adds. At Memorial Hermann, most primary care physicians requested the hospital system's Advanced Primary Care Practices program, says Griffin, with most doctors saying "it was important for their future."
Memorial Hermann's medical home program includes a team of physicians, nurses, and other caregivers who treat acute and chronic medical conditions and oversee wellness programs. A key element is the embedding of an innovative information technology into the care registry exchange, which is designed to enable physicians in the Advanced Primary Care Practices program to share clinical data with each other in a privacy-protected manner that will help avoid unnecessary duplication of medical services, according to the hospital system.
Physicians can be prompted to order and schedule needed tests and vaccinations, or be alerted to changes in medications made by other physicians. They also can be notified of abnormal lab values and prompted to intervene appropriately.
"Primary care is the future," Griffin says. "They are critical to the success of the medical home and coordination of care; it's giving patients the right care and access to care."
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