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Payer Launches Joint Venture to Support Independent Physician Practices

Analysis  |  By Christopher Cheney  
   July 09, 2021

The new joint venture in North Carolina will help independent physician practices by easing administrative burdens and bolstering value-based care capabilities.

A new joint venture in North Carolina that pairs a payer with a management services company is designed to support independent physician practices during the shift to value-based care.

In today's market, independent physician practices face a range of challenges to maintain their operations. In particular, independent physician practices must deal with burdensome administrative functions and develop new capabilities to achieve success in value-based care contracts.

The joint venture is being formed by Blue Cross and Blue Shield of North Carolina (Blue Cross NC) and New York, New York-based Deerfield Management Company. Von Nguyen, MD, MPH, senior vice president and CMO of Blue Cross NC says the payer entered the joint venture for two reasons.

"First, we are very much aligned upon providing options for physician practices to remain independent. The other reason we are doing this is as we look at healthcare, we fundamentally believe that value-based care is the future. When you look beyond the day-to-day administrative tasks, there is an opportunity through people, processes, and technologies to bring new opportunities and new ideas to smaller practices. It can be really challenging to run a practice and learn new capabilities, so this the joint venture is a way to support physician practices as they grow in this new value-based care environment," he says.

Nguyen says there are three broad categories where the joint venture will support independent physician practices—people, processes, and technologies.

  • "For people, we can help with the staffing of mainly the nonclinical staff. We want to bring in the right staff to support providers at scale. You can imagine that one provider might not need a pharmacist but having a pharmacist across multiple physician practices might make a lot of sense," he says.
     
  • "For processes, there is an opportunity to learn from each other. During the COVID pandemic, physician practices were trying to figure out new ways to see patients and keep them safe. You can imagine that through the joint venture, a provider could quickly call and inquire about keeping patients safe, maintaining social distancing, and scheduling appropriately between visits," he says.
     
  • "For technology, COVID provides another good example of the potential of the joint venture. Telehealth was all the rage during the pandemic, but there are many platforms for providing telehealth, including Zoom, Skype, WebEx, and Teams. The joint venture can help physician practices choose the right virtual solution," he says.

 A primary goal of the joint venture is helping independent physician practices cope with administrative burdens, Nguyen says.

"As we think about this joint venture with Deerfield, it offers an opportunity to get providers out of a cycle where they can focus on their job of providing quality care to patients and leave administrative tasks to a different organization—an organization that is run by this joint venture. This new organization can take care of everything from scheduling, to hiring staff, to making sure rent is paid. All of those administrative tasks are handled—allowing the provider to spend time with patients," he says.

Supporting adoption of value-based care

Another top goal of the joint venture is supporting independent physician practices in the shift to value-based care, Nguyen says.

"In value-based care, you need to think about new capabilities that you need to bring to bear. You need to make sure that you have enough dollars in the bank for when you have bad years. You need to think about care coordination differently. You need to think about keeping patients healthy—you do not make money by seeing patients in the clinic, you make money by keeping patients out of the clinic. Providers need to think about the tools they need to keep patients healthy at home," he says.

The joint venture will support independent physician practices in their journey to adopting value-based care, says Adam Grossman, MBA, a partner at Deerfield. "This is a multi-year process that requires a lot of infrastructure to support practices as they adopt new tools and resources to make the transition to value-based care. So, whether it is helping practices to evaluate the right technology tools, helping practices with relationships in the provider community, or helping practices with contracting, there are several areas where support is needed."

Applying Deerfield's resources

Deerfield has two assets that will play key roles in the joint venture, Grossman says.

"One, we have the Deerfield Institute, which has been in existence for about 15 years. The institute has a lot of capabilities. For example, we can help practices understand different geographies, we can help practices understand market access, and we have an epidemiology team. There are a lot of capabilities within the Deerfield Institute that the joint venture can leverage over time."

"The second component is the Deerfield operations team. That is a group focused on building businesses. This team can help the joint venture figure out accounting and financial management, or information technology, or human resources and talent acquisition. A lot of the business building that is required for the joint venture will be supported by the operations team," he says.

Related: Coronavirus Pandemic Driving Increase in Healthcare Consolidation

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.


KEY TAKEAWAYS

Blue Cross and Blue Shield of North Carolina launched the joint venture to sustain independent physician practices and help them make the shift to value-based care.

A focal point of the joint venture will be helping independent physician practices manage administrative functions, including patient scheduling and hiring staff.

The joint venture will help independent physician practices develop essential capabilities for value-based care such as care coordination and contracting.


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