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Wednesday May 16, 2012

Working With Others Key to Successfully Transforming Our Practices

Good partners can make all the difference when transforming a practice.

For example, one of the family physicians in my practice, Andrew Drabick, M.D., was so concerned about the obesity problem in our community that he led our efforts to open a weight loss clinic. Many of our patients found the extra help they needed, and we added an important revenue stream.

One of my other partners, Stephen Moore, M.D., is passionate about practicing family medicine, but he has little desire to be involved in the business of medicine. Stephen puts his trust in others to make sure we are running a sound business. I also love being a family physician, but I have the interest in business that my partner lacks. Together, we provide balance to a practice that has expanded three times in a little more than five years.

We not only have doubled the physical size of the practice, we grew from three physicians and one nurse practitioner to five physicians, two nurse practitioners, one physician assistant and a dietician, as well as an athletic trainer who works with us on a contract basis and a massage therapist who rents space from us.

However, our partners aren't limited to those who work in our office. We've succeeded in improving and transforming our practice because we've been willing to branch out, reach out and find like-minded people who are willing to help us lower our costs while improving care.

One example is the independent practice association (IPA) we've belonged to for more than a decade. The IPA represents about 145 physicians from nearly 50 practices. Members learn best practices from each other, which makes us more efficient and helps us improve outcomes.

Two years ago, the IPA mandated that by the end of 2011, every participating practice had to reach National Committee for Quality Assurance (NCQA) Level 2 or 3 patient-centered medical home (PCMH) recognition. Amazingly, the IPA group lost only three practices, added four new ones and has others interested in joining.

Our practice achieved NCQA Level 3 recognition in 2010. It wasn't easy, but being a member of the IPA made a difference. The organization used funds from member dues and pay-for-performance funds to hire a consultant who helped practices with paperwork related to the process.

Our commitment to the PCMH model already is paying off. Blue Cross and Blue Shield of North Carolina, which covers half our patient population, offers higher fee-for-service payments to primary care physicians who provide patient-centered care. Practices must meet certain criteria, including NCQA recognition.

Due to the IPA’s successes and data proving we help control costs, other businesses and insurers have approached us as well. These opportunities have tremendous potential.

Some physicians are overwhelmed by the thought of the work and investment practice transformation requires. For my practice, it was worth it. Thanks in part to Blue Cross, we experienced more than a 10 percent increase in revenue last year with no significant increase in patient volume. After having almost $2 million in collections in 2010, that 10 percent increase was significant. 

We owe some of our success with Blue Cross to yet another partnership -- our involvement with the North Carolina AFP. Our state chapter has been communicating with the health plan for years about the value of primary care. BCBS is starting to get the message and responding with improved payments.

Though individual FPs might not know the key contacts of a state health plan, your state chapter likely does. They are great resources.

Help is there, if you know where to look. The Academy has numerous resources available, and the AAFP and its wholly-owned subsidiary TransforMED recently made Delta Exchange -- a social networking resource focused on practice transformation -- free to Academy members

The bottom line is that you don't have to go through practice transformation alone. By partnering with the right people and getting the right pieces in place -- both inside and outside of your practice -- you can learn how to make your practice more efficient, more profitable and more enjoyable.

The business of medicine is changing. Are you?

Conrad Flick, M.D.of Cary, N.C., is a third-year member of the AAFP Board of Directors.

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