Value Based Care Has Created New Business Models for Private Physicians

About 60% of doctors are continuing in the private practice of medicine in an attempt to hold on to traditional healthcare. Nonetheless, the industry is shifting towards new payment methods. Dr. Harold Miller, president and CEO of the Center for Healthcare Quality and Payment Reform, claims that physicians would have to slow Medicare spending by 0.5% per year over the next 10 years in order to achieve the savings for SGR repeal. Physicians in Dallas are innovating ways to remain independent without finding employment with large healthcare systems.

A local group of independent physicians in Dallas are pooling their resources to launch a physician-directed clinically integrated network. The result is approximately 400 primary care physicians and specialists that have contracted with both the government and commercial payers to care for more than 20,000 patients in new Accountable Payment Models. It allows the doctors to continue with traditional fee-for-service payer contracts, while also moving toward Accountable Care Organization contracting. Ultimately, this strategy allows for a smoother transition because the current fee-for-service payment model poses as a barrier to clinical integration. Currently, physicians who reduce unnecessary utilization and costs are not compensated in traditional fee-for-service contracts.

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Caroline Smith is currently a senior at the University of Notre Dame and is a contributor to Medical Groups. She is majoring in Science-Business and Spanish. After graduation, Caroline plans on entering the field of healthcare consulting. She is most interested in the evolving policy changes in the healthcare industry and enjoys learning about new technologies that are being developed.