Value Based Payment

A Closer Look at a Medical Group’s Strategic Options

November 13, 2014 4:42 pm

The independent medical group has several options regarding its future strategy. Indeed, many groups pursue more than one strategy at once.
Here is an example of a single specialty orthopedic group’s strategy: 

  • Merge with a (formerly) competing orthopedic group. Rationale: cover more geography, enable the group to support a sports medicine practice, enable the group to have its own rehabilitation group, support more hospitals more effectively, support a stronger professional management team, and support additional orthopedic sub-specialization.
  • Initiate a bundled payment initiative. Rationale: learn (along with a partner health system) to manage all elements of the care process in a value-based payment environment, and gain additional revenues once successful.
  • Integrate IT approaches with as much as possible of the referral base (including EHR, decision-support, and other elements). Rationale: an essential step in accomplishing the other elements of the group’s strategy, with the potential to reduce the group’s total IT costs.
  • Provide leadership in developing a CIN. Rationale: expand and shore up key parts of the group’s referral network, lead the development of an integrated approach to care management for the group’s patients (including total joints, trauma, and other areas), influence the development of the CIN’s funds flow and compensation models, and influence the alliances and other relationships developed by the CIN.

Together, the orthopedic group’s strategies seek to make the transition from fee-for-service to value-based payments, to enhance short-term revenues and market position, and to make the group more successful in recruiting.

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