The Federal Trade Commission’s (FTC) Bureau of Competition has advised TriState Health Partners, Inc., a physician-hospital organization based in Hagerstown, Maryland, that it has no present intention to recommend that the FTC challenge the organization’s proposed clinical integration program. The program would integrate and coordinate the provision of medical care services to patients by TriState’s more than 200 physician members, as well as with the Washington County Hospital, also a participant in the program. It would also include joint contracting by the program’s members with health plans and self-insured employers.
Under the program, physicians will be subject to a variety of requirements regarding their performance, including adherence to clinical practice guidelines being developed by TriState’s participants. Physicians also must make certain financial and personal contributions of time and effort toward the success of the program, such as working on various committees. Physicians generally will be required to use other providers within the network when making needed referrals, and the program will monitor and oversee physicians’ performance in following best practice standards and in meeting both individual and group performance goals and benchmarks. The proposed program will make extensive use of a web-based health IT system, including electronic health records, to help identify patients and providers where various interventions would be most productive in improving care and patient outcomes, and to facilitate those interventions.
TriState’s program will be non-exclusive, so that purchasers and payers who do not wish to buy it will be free to contract directly with TriState’s individual participants. Likewise, access to the services of Washington County Hospital will not be tied to the TriState program, but will be separately available to purchasers and payers. TriState also will implement various information protections in its program’s operation to minimize the possibility of any anticompetitive effects in the market outside the program.
Read the FTC’s press release.
