Built-in Medical Providers (IMS) is the most important physician-owned multi-specialty supplier group in Arizona, with greater than 75 suppliers throughout 9 specialties. IMS CEO Monique Delgado not too long ago spoke with Healthcare Innovation in regards to the supplier group’s development and its involvement in value-based care fashions.
IMS had beforehand been owned by the Dignity Well being System, however grew to become an unbiased supplier group in January 2023. Since changing into unbiased, IMS has skilled a 30 % development in suppliers, together with 5 new areas and two main care follow acquisitions in only one 12 months, and now serves greater than 20,000 sufferers throughout the value-based care continuum. As well as, IMS reported a 92 % affected person satisfaction charge as measured by an exterior survey companion, a metric that improved considerably over the previous 12 months.
Talking about her background, Delgado stated that when ACOs got here on the scene a couple of decade in the past, she joined one of many first ACOs in Arizona. “I had the privilege of working throughout the complete valley with main care and specialists to assist educate and prepare suppliers on shifting from payment for service to value-based care and accountable care. So during the last decade, I supported main care unbiased practices by way of an ACO or IPA mannequin, after which came visiting to assist IMS scale the group and achieve their independence again.”
Delgado stated she has spent the final 12 months unraveling a few of the contracts IMS was in. “IMS traditionally had probably not taken benefit of its measurement,” she defined. “We’re the most important unbiased multi-specialty group, the largest unbiased follow basically in Arizona and we did not have direct contracts with the payers. However actually we have been too massive to be with an aggregator. It does not make sense for us. We now have sufficient ability to have direct contracts with the payers, so I’ve strategically checked out every contract the place it made sense for us to go to danger straight and we have efficiently been capable of negotiate these contracts and transfer them away from the aggregators.”
In earlier organizations she led that have been in main care with risk-based contracts, she defined, one of many hardest issues to manage was the whole price of care, and the vast majority of that’s skilled spend. “You’re making an attempt to work with 20 totally different specialists. Right here, we even have them beneath our similar umbrella, so we are able to determine cardiology spend and we are able to apply a medical protocol if we have to. Our capability to coordinate more practical care with our personal cardiologists truly creates higher compliance. We now have significantly better management over that complete price of care.”
Delgado stated one of many keys to success is the supplier group’s deepening relationship with well being IT vendor athenahealth, and the creation of a single well being IT platform throughout the group. Traditionally, she stated, having a number of EHRs has been a giant problem in value-based care and inhabitants well being efforts. “In my earlier roles, the place we had a number of practices, you might need 55 disparate EMRs that you just’re making an attempt to combination. So right here now we have one occasion, one product,” she stated. “Athena personalized totally different templates inside the system in an effort to have the system work for cardiologists, work for PCPs and work for our orthopedists. We now have a single occasion and the affected person has one report. That has been tremendously useful. Any supplier that we convey on or any any follow that we purchase comes onto that occasion.”
As IMS integrates practices, it will probably do this seamlessly as a result of it brings them onto the identical system that everyone else is on, Delgado stated. “As well as, we’re independently owned and physicians can are available in and truly be homeowners of of the group.”
She stated the income cycle assist is robust as nicely. “We now have a few of the greatest stats that I’ve seen in unbiased practices and partly that is because of the relationship now we have with athena. As an illustration, we run a 3.9 % denial charge. The typical commonplace is like 6 %, in order that’s big. In regard to information analytics, we’ve deployed a brand new performance, Information View, with athena, and that takes all of the back-end information that now we have from athena, and it will probably ingest the exterior information that we’re getting from our payer companions, which permits us to take the real-time information of what we all know is occurring within the clinic with the affected person and likewise that trended information in order that we are able to get a greater view of what is occurring in our inhabitants and apply interventions, medical protocols, or outreach to the affected person as wanted.”
“If you happen to wait on the payer information that you just get, you are behind, as a result of there is a claims lag, so that you’re taking a look at what’s already taken place. We will truly see forward of what the well being plan has earlier than the declare has even been submitted,” Delgado stated. “We all know what’s occurring with our inhabitants, and that actually helps conversations after we’re assembly with our well being plan companions.”
