How 1 physician group achieved an 85% net promoter score

Practice Management

Columbus-based Central Ohio Primary Care is the nation's largest independent primary care physician group and an industry leader in physician engagement.

COPC partnered with agilon health, which aims to help physician groups implement programs to spend less time on business administration and more time with patients. COPC CEO William Wulf, MD, and agilon health CEO Ron Kuerbitz recently spoke with Becker's Spine Review about net promoter scores and shifting practice culture to adapt to value-based care.

Question: What is the importance of a high net promoter score for physician practices?

Dr. William Wulf: Net promoter score is a common metric for physician engagement and patient experience. We believe there is a connection between the two — physicians who are satisfied with their practice environment deliver better patient care.

We are extremely proud that our NPS from physicians is an industry-leading 85, which basically means there are 85 percent more physician promoters within our practice than detractors. When you bring 350 physicians together under one common clinical vision and governance structure, achieving that level of satisfaction doesn't happen on its own. Many of our strategies and initiatives are designed to improve the lives of our physicians.

We also measure how satisfied our patients are with the care and service they receive from our physicians. For example, we recently surveyed patients that participate in our COPC Senior Care Advantage program, and more than 95 percent of them attend their annual wellness visits. and many of them say they love the focused time and attention from their COPC physician.

As a result of our partnership with agilon health, we were able to launch a global risk program in 2017 for our Medicare Advantage patients, and today, more than 25,0000 COPC patients are benefitting from it. Aagilon health's platform, which delivers an integrated people, process and technology solution through a deeply-aligned partnership with our physician group, has allowed us to develop a Medicare Advantage-focused service line without sacrificing our independence and practice culture.

Question: What were the key contributors to your high score? What makes the difference?

WW: While COPC's philosophy has always been to include our physicians in the practice's decision-making process, we are now involving them even more. One physician representative from each of the 67 clinics attends a monthly advisory committee meeting. Today, more than 80 percent of COPC physicians are shareholders, and, therefore, are financially rewarded for contributing to the success of the practice. Also, all COPC physicians are incentivized for their ability to deliver quality patient care.

In addition to our governance model, we believe that our commitment as a practice to value-based care is a significant contributor to physician satisfaction. Working with the leadership of agilon health, we have implemented new strategies, such as centralized referral management; new sites of care, including a high-risk clinic; increased clinical assistance from nurse practitioners and other healthcare professionals and improved patient engagement, to name a few. These strategies allow our physicians to spend more quality time with their patients and provide them with even more comprehensive healthcare.

Q: How does this raise the bar for other physician groups?

Ron Kuerbitz: The U.S. healthcare system is in the midst of systematic change for primary care physicians. Physician burnout is becoming endemic, patient mix is quickly shifting to Medicare and Medicare Advantage, payer mix is shifting to risk-based payment, and the demands for quality care coordination systems are greater than ever. However, from our perspective, the market does not offer primary care physicians an effective model to capture the emerging opportunity.

With agilon health's help, the COPC model is paying off. This year, the organization has added 10 new physicians, and the practice's Medicare Advantage patient population has grown more than 10 percent. COPC is thriving as a result of this growth and enhancing its position of the 'practice of choice,' which makes it attractive to new physician talent and further strengthens its competitive position in the marketplace.

Besides COPC, agilon health is assisting other U.S. physician practices to stay ahead of the curve by providing them with a platform to leap from fee-for-service to value-based care. We are beginning to see this virtuous cycle with our other partner practices, including primary care groups in Austin, [Texas], and Akron, [Ohio]. Within the next two years, we expect to provide our technology-enabled risk services to a total of 15 markets across the U.S.

Q: Do you think the net promoter scores will become part of a national trend?

RK: Yes. The continued commitment to measuring physician engagement underlines its importance in the success and sustainability of our healthcare system. And the net promoter score is an excellent tool for measuring the overall satisfaction rate of physicians.

Shortages of primary care physicians, aging populations, and the complexity of changing reimbursement systems and program puts a tremendous amount of strain on many physician practices. On a daily basis, physicians find themselves on the front lines of this transition from fee-for-service to high-quality, value-based care, often without a partner to help or a business model to use as a guide. It's important for physician groups to seek outside help during this difficult transitional time.

Personally, I think the deep commitment we make to our partner practices not only engages them at the organization level, but also touches each individual physician. Our physician leaders and the agilon health team agrees with those tenets and we've built a company to cultivate that.

Q: How did the practice have to shift its culture to get this score?

WW: We realize that physicians want to work in an environment where they are appreciated, and their time and input are valued. At COPC, physicians continue to be more involved in the decision making and are financially rewarded and incentivized. COPC is leading the way nationally through its adoption of a successful value-based care model, but we know that our practice must continue to evolve with the changes in the marketplace. We want to provide our physicians complete transparency for the quality and cost of the care we manage and the utilization trends of all providers in the network. We strive to give them the opportunity to spend the right amount of time with the right patient. And most of all, we want them to remain independent. Physicians who feel they contribute and are engaged in the practice are one of the main reasons that COPC continues to be an industry leader, offering high-quality and accountable care for patients.


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