Saint Mary's creates new docs' group

May 28, 2010
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Doctors from Advantage Health will join those employed by Saint Mary’s Health Care in a new multispecialty group to be owned by the hospital and tentatively called Advantage Health/Saint Mary’s Medical Group.

Vice President of Medical Affairs Dr. David Baumgartner said about 120 Advantage Health’s primary care physicians will join around 50 specialists who are already on Saint Mary’s payroll to create the 170-doctor organization.

He said the multi-specialty group will work closely with 400 independent physicians in greater Grand Rapids who have joined Carepath Partners, a clinical integration organization, to work more closely with the hospital and its employed doctors on issues such as electronic health records, referrals, insurance and evidence-based clinical standards.

“We expect that over time, employers will begin to see that the care being provided here is not only high quality, but that we are able to put the brakes on some of the rising costs of health care,” he said.

The medical group also intends to focus on patient care with the use of evidence-based standards and goals that would be shared by the independent doctors who are part of Carepath Partners. Baumgartner said that eventually patients should see easier access to care and improved quality of care.

Dr. Bruce Shabahang, a thoracic oncology surgeon who, with Baumgartner, sits on the AH/SM Medical Group board of directors, said the two-pronged approach at Saint Mary’s is unique and serves as a pilot program for Trinity Health, which owns the hospital and 47 others across the country.

“This is unique,” Shabahang said. “All eyes are upon Saint Mary’s. The Trinity Health system wants to see if this model works. If it works, we’re going to be the model that Trinity will use at other hospitals.”

Saint Mary’s employed doctors are primarily specialists, some specifically hired as part of the effort to build capacity for the Michigan State University College of Human Medicine’s Grand Rapids campus, Baumgartner said. Advantage Health consists mostly of primary care doctors.

Working with Carepath Partners will provide for a common ground between doctors in the new medical group and those who opt to remain independent, he said.

“Over the last 10 years or so, we’ve hired a number of physicians, mostly in specialties to meet specific needs within the community that we’ve identified,” Baumgartner said. “Now, as we’ve gotten bigger, it makes sense to try to get these employed physicians and Advantage Health physicians into the same organization.

“We think that will really strengthen the practice of both the specialists and the primary care physicians by getting them into an aligned organization.”

Baumgartner said the medical group would be prepared to accept changes that are anticipated in the way that health care providers are paid by Medicare, and eventually by commercial insurers. One lump sum would be shared by various providers to pay for one episode of care for a patient.

“When we started this work maybe 2½ years ago, there was a lot of speculation about what health care reform was going to mean and how it was going to happen,” Baumgartner said. “What we realized is that we need to be organized in different ways than we have before. We need to be much more significantly organized in a way that we can respond to different approaches to payment systems, different incentives that may come from third-party insurers.”

In addition to sharing clinical goals with the new medical group, independent doctors who belong to Carepath Partners also will be able to purchases services such as electronic medical records and human resources support, Baumgartner said. That option is meant to address the challenges that independent doctors face with the ever-increasing complexity of dealing with the business side of medicine, he added.

He and Shabahang both said that model has drawn some interest from doctors associated with Spectrum Health who are reluctant to give up independent practice to join the dominant health system’s medical group.

“One of the things we’ve tried very hard to do in our approach to our alignment is to do it in such a way that there is plenty of room for independent physicians,” he said. “Our end game is definitely not to employ all the physicians on our medical staff. We know there are a number of physicians who would like to stay independent.

“We have had discussions with physicians who have been part of the Spectrum system,” Baumgartner said. “We have ongoing discussions with them, and we’ve had physicians who have left Spectrum and both come into our independent groups and come into our employ. So we are seeing some of that occurring.”

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