Independent physicians need an ally. Provider practices are consolidating everywhere. Hospital systems are assuming control and purport to represent the physician perspective. In a two-year period, the 2,800 U.S. hospital systems have bought 8,000 medical practices.
National health insurers are also in the fray, now buying regional medical groups. United Healthcare has purchased the largest independent medical practice in Massachusetts. United, Aetna, and Cigna aren’t yet a significant presence in Buffalo or Rochester, but when that occurs, relationships will change.
In this new environment, Cornerstone Healthcare Consulting and Management represents group practices, sole practitioners, and hospital – employed doctors. Working as an employee for a healthcare system does not eliminate the need for an independent brand identity.
We are the physician’s “agent” – whatever is needed, we provide analysis and insight. As important, we implement our recommendations. Our functions can include marketing, branding, medical billing, the opening of a new practice, or a merger with another. All services are confidential, of course.
Being aware of industry trends is essential to our business. The rising cost of medical care to Medicare, Medicaid, and Commercial (employer) budgets has put pressure on payer/provider relationships.
Western New York is not immune to the dynamic. Why did UPMC/Pittsburgh, itself both a hospital system and health insurer, buy WCA Hospital in Jamestown? Why did HealthNow Blue Cross allow itself to be taken over by Highmark/Pittsburgh and what will it mean to Buffalo providers?
The ultimate healthcare goal is to serve the patient; their needs get lost in the typical shuffle. Health plan deductibles have increased dramatically, and some medical groups perform front-end credit checks on new patients. Access to primary care is a major problem.
As Cornerstone moves forward, it has partnered with Azeros Health Plans in developing an Exclusive Provider Organization which offers visit capacity while eliminating co-pays. The EPO model offers much needed physician independence, access to primary care, and cost control.
We want to be the trusted advisor of the medical practice. No job is too big or too small. Schedule a consultation via our website at www.cornerstonehealthcareconsulting.com.
