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ACOs Shine Spotlight on Physician Employment

Carrie Vaughan, for HealthLeaders Media, May 10, 2011

"We started out whole-as a strong financial performer with a strong drive to grow, the ability to recruit providers, and great quality scores," says Mary Barton Durfee, MD, IHA's executive vice president and CMO. "The driver was improved patient care. We thought we could do an even better job by having partners."

IHA, an Ann Arbor, MI-based multispecialty practice with more than 200 providers, including physicians, nurse practitioners, and physician assistants, was approached by Trinity Health about developing something different than a referring relationship.

"We were flattered by the approach and request, but initially decided that we'd pass," says Cindy Elliott, MHA, IHA's executive vice president and COO.

But after further review by the board, IHA determined that it was in the best interest of the group and its patients to enter into the strategic partnership with Trinity, which was completed in December 2010. "We had been very focused on the quality outcomes of our patients, but so many of those outcomes are systemwide," says Durfee. "To get better outcomes and care coordination and keep people from being readmitted in the hospital, we felt that a partnership was in the best interest of our patients."

The whole process took about nine months, with IHA becoming a wholly owned subsidiary of Saint Joseph's, says ­Elliott. "Our physicians are still employed by IHA, and our name, brand, and the way we present to the public is still IHA."

Key to the partnership's success is that IHA's CEO and CMO now have seats on Saint Joseph's board, and vice versa. It is important to be able to evaluate all the opportunities that come up on a daily basis, says Elliott. "It is really helpful having those folks around the table who can listen to those discussions and be helpful in directing the next steps."

Tips for a seamless transition to an employment model
Transitioning to an employment model is not without its ­hazards. Take this advice from executives and physicians:

  • Don't lose yourself in the transition. Know what is important to you and stay close to your mission and values.
  • Be meticulous. Keeping patients first and preserving the culture were top priorities, says Mary Barton Durfee, MD, executive vice president and CMO of IHA. "Everything we did reinforced that approach. It was thoughtful and we spent a huge amount of time on the details. It was well worth the time invested."
  • Determine cultural fit. It is important to understand the organization's corporate mission and culture. "Make it a point to talk with current and past provider employees with permission of the system," says endocrinologist Karl David McCowen, MD. "If the system doesn't give permission, then get up and walk away."
  • Know the expectations. Read the organization's provider handbook.
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