Physician Owned Small Practices Contribute High Value

Smaller physician-owned practices have a lot to contribute to the healthcare conversation, even when practice consolidation and hospital ownership are the name of the care delivery game in many areas. This insight comes not from a lonely rural practitioner, but from Dr. Farzad Mostashari, former national coordinator for health information technology at the US Department of Health and Human Services.

“Small, independent primary care practices are not unevolved primates; evidence instead suggests they are uniquely situated to thrive in delivering value-based care,” Mostashari recently wrote in the Annals of Family Medicine. He cited evidence that small, physician-owned practices provide a greater level of personalization and responsiveness to patient needs, have lower average per-patient costs, and lower readmission rates than larger, independent, and hospital-owned practices.

If value-based healthcare maximizes value for patients—i.e., delivers the best outcomes at the lowest cost—that’s precisely what many smaller practices offer, often out of necessity. Providers see the value-based model as a way to rein in costs and keep patients healthier longer. In addition, payers are getting serious about making quality and outcomes part of their reimbursement formulas, Medical Economics reports.

“We must move away from a supply-driven healthcare system organized around what physicians do and toward a patient-centered system organized around what patients need,” Michael Porter and Dr. Thomas Lee, declared in Harvard Business Review.

However, what physicians do and what patients need are not always antithetical. One study out of California found that patients who consistently see the same primary care provider receive better coordinated care, and have fewer hospitalizations and emergency department visits.

Value-based reimbursement programs are transforming healthcare and the way practices are paid. To succeed in these programs, practices must effectively track, manage, and positively affect population health. In many cases, that requires new workflows and processes. To boost the prognosis for success in the value-based world, there are several things smaller practices must do:

• Prepare for value-based reimbursements
• Build workflows that successfully integrate care coordination and patient engagement
• Identify and measure the processes that boost performance under value-based contracts
• Understand the role of data and analytics in population health management

In a 2014 post, Medical Economics predicted that in the next two to five years, the shift from fee-for-service to value-based reimbursement will accelerate, adding even greater urgency for physicians to better understand payment reform and plan to adapt. Many small practices are already well on their way.