In a heavily employed healthcare environment, independent physicians may fare better joining together to meet the demands of value-based care and contracting.
North Texas CIN, a Dallas-based accountable care organization, is providing the platform for more than 1,100 independent physicians to ban together to face the tide of change. The participating physicians all maintain their autonomy as they continue to head their own practices, both in the primary care and specialty sectors.
Called TXCIN for short, the ACO jumped around Texas' corporate practice of medicine law by establishing itself as a 501A organization. Independent physicians created TXCIN in late 2014 with the mission of helping other independent physicians enter into value-based contracting, holding participants accountable for quality, efficiency and patient satisfaction.
TXCIN saw significant growth in the first half of 2016, aligning with three independent practice associations encompassing between 2,800 and 3,000 physician members. So far, about 1,100 of these IPA physician members have agreed to enter the first commercial ACO contracts.
"The physicians independently determine whether they want to be in TXCIN's value-based ACO contracts or whether they want to participate through other ACOs in the community," says Jim Walton, DO, MBA, president and CEO of TXCIN. The ACO currently serves approximately 90,000 Blue Cross Blue Shield members and 15,000 Cigna members in North Texas.
With a higher than average rate of healthcare costs, North Texas presented an opportunity for an organization like TXCIN to thrive.
"North Texas has not been able to significantly bend the cost curve with existing models of physician networks, particularly those that are aligned with regional health systems," Dr. Walton says.
If independent physicians collectively embraced value-based care outside of hospitals, they have the potential to "move the needle faster while better controlling the rate of rising costs," adds Dr. Walton. Additionally, he believes a value-based market must offer an independent solution, as not all physicians want to be employed or controlled by health systems.
"The impact is that all boats will rise as independent physicians become more discerning in how to apply population management methods to a larger number of patients in their panel," Dr. Walton says. "Independent physicians are just the most recent expression of moving population management to all physicians that take care of patients in North Texas."
In order to succeed in the value-based care arena, TXCIN implemented real-time, web-based software to cut healthcare spending and enhance patient care. All participating TXCIN physicians use Dallas-based revelationMD technology. The technology allows providers to see how they are performing in real time, in terms of quality and efficiency. The physicians also use revelationMD to make referrals to more efficient outpatient services or specialists.
Since independent physicians utilize varying electronic medical record systems, revelationMD helps streamline data. The technology essentially serves as a "new software tool that helps to connect and extract clinical data from physicians and make it available at the point of care," explains Dr. Walton.
Ultimately, Dr. Walton sees population management skills as the key to success in value-based care contracting, while adding that "independent physicians' total costs of care is historically more cost efficient than their hospital-employed colleagues."
"We are working to preserve the option for physicians who want to be independent entrepreneurs of their own private practices, so communities and patients don't have to rely on the total corporatization of medicine to control costs and improve quality," says Dr. Walton.