As UPMC and Highmark Health fight for dominance of the health care market in Western Pennsylvania, it can be easy to forget that some physician practices are independent and want to stay that way.
Genesis Medical Associates Inc., a practice of 20 physicians based in Ross, is forging its own path through the market that’s increasingly complicated by local economics and federal regulation. Mark Kissinger, the practice’s executive director, said the group can be successful, even if that means turning down acquisition offers from the big systems.
“They want to care for their patients, and they don’t want somebody else telling them how to do that,” Kissinger said.
Kissinger discussed the challenges of remaining independent and changing the way Genesis manages patients to meet government mandates in a recent interview with the Tribune-Review. Below are edited excerpts.
Trib: I imagine it hasn’t been easy to remain independent with the growth of large health systems?
Kissinger: It hasn’t been easy. We know that both systems — UPMC and Allegheny Health Network in coordination with Highmark — there’s no doubt that they have been very active in the acquisition market. They want to secure their patients, their referrals. We have received formal offers, and the offers have been amazing. Yet, our physicians have a business savvy, an understanding of risk, and at the same time the ability to recognize their job is to evolve with the industry. We can evolve into whatever organization will be successful here rather than turning it over to someone else.
Trib: One of the issues that has caused practices to sell has been investments in technology. How have you dealt with that?
Kissinger: We moved to an electronic medical record at the end of 2007. No doubt, it’s a challenge. We are in the process of evaluating the decision to move into a new product for those services. Our patient portal is very helpful for our patients to access their medical records, but it’s not as user-friendly as I need it to be. But part of what has made us successful is continuing to look at what tools do we need. Last year, we developed an app for same-day appointment scheduling. That’s the kind of thing we have to be more proactive about.
Trib: What else are you doing to be more consumer-friendly?
Kissinger: All of our practices have evening hours, several of our practices have Saturday morning hours, and we did go to a walk-in clinic at our office in the Wexford Pavilion. One of our goals is, at some of our practices, to move to Saturday afternoon hours and at least a Sunday morning set of hours for our patients to be seen.
Trib: How are Medicare and the Affordable Care Act changing your practice?
Kissinger: We have to maintain the highest level of quality and patient care, but at the same time control cost. The government is saying, you need to control costs. Medicare has a shared savings program. Genesis and Preferred Primary Care Physicians created a partnership that manages 7,400 Medicare lives in a contract that defines 30-some quality measures that you have to maintain. But if you’re able to save costs, you get 50 percent of those savings. You can’t control costs at the expense of quality.
Trib: Does it seem like these programs are working?
Kissinger: We very strongly believe that the more information that you can give the primary care physician, the better position we will be in to coordinate that care. That requires data. The data we’ve seen from Medicare by far surpasses anything we’ve seen from our insurance carriers. There is no doubt that when presented these metrics, our physicians will have the information to collaborate with their patients.
Trib: And then make educated decisions about where to go for care, correct?
Kissinger: Correct. For example, we have the meaningful use program, which incentivizes physicians to get electronic medical record systems. Primary care physicians haven’t been good at tracking referrals, and the statistics related to patients following up (with specialists) isn’t good. Through our system, we see when they make the appointment, and we’ll know whether they see the patient, and then we’ll get an electronic consult that comes back. What it really helps to do is find the specialists who want to work with us on managing that patient.
Trib: Is there any danger that specialists owned by large systems aren’t going to want to work with you?
Kissinger: Based on our geographic footprint, both systems want to work closely with us, as do their specialists. Their specialists aren’t necessarily guaranteed a check, so they need to see the patients. We are anxious about the concerns between UPMC and AHN, but we see patients at UPMC Passavant and at Allegheny General Hospital. We accept all patient insurances.
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