Laura Jacobs, executive VP of the Camden Group and speaker at the recent American Hospital Association summit, expects more independent doctors in Orange County to join a medical group or health system to meet payers’ demands for better managed care at lower costs driven by the changing health environment.
The upside is that doctors who are part of a wider network will reap certain benefits, Jacobs told PNN during a recent interview. Jacobs spoke about clinical integration trends, among others, at the recent American Hospital Association Health Summit.
“To be (successful and) independent today, you also need to have a relationship with a network,” Jacobs said. “Doctors have to be a part of a network; otherwise, payers will reduce fee-for-service revenues to contain costs, and if you’re part of a network you can work together to manage care better and have the opportunity for shared savings and (get) incentives payers provide.”
With hundreds of thousands of newly insured, local medical groups, such as HealthCare Partners Medical Group and the Heritage Provider Network, and hospital systems, such as MemorialCare Health System and Providence Health and Services, will be looking at independent doctors, especially primary care doctors, to join their networks, she said.
Jacobs noted that physicians who join these networks need to play by their rules.
Doctors who join a network—whether it’s an Independent Physician Association or Accountable Care Organization—will become part of their wider electronic health systems network and be required to fulfill their specific requirements.
These can include specifications on how to provide clinical data and how to report quality of care data and developing clinical guidelines. Doctors also need to be prepared to participate in committee meetings, etc.
Jacobs said that for Orange County physicians who are involved in multiple IPAs today it may be more practical to stay with just one partner to meet their requirements, given the complex and uncertain issues surrounding health reform.
Independent doctors who don’t want to join a network may have to come up with a different business model, she predicted.
“They need to think about how they will access a competitive marketplace,” Jacobs said.