Physician Integration Expansion at Methodist - January 13, 2013

January 13, 2013 12:00 am

For several decades, most physicians and hospitals worked with each other independently. Over time, these arm’s length, fee-for-service arrangements were seen as contributing to rising health care costs and significantly driving uncoordinated care, duplication of services and inadequate patient access.

As a result, the idea of healthcare reform became part of the national agenda many years ago. Members of both the legislative and medical communities, along with the general public, knew they needed a plan to address it.

Now, the health-care reform law (the Patient Protection and Affordable Care Act or Obamacare as it is more commonly called) includes new health information technology requirements among other widely debated reforms, which are slated to be put into play starting next year.

“Physicians are generally independent by nature,” Methodist Hospitals Vice President of Physician Integration Jim Kirchner said. “From the very beginning of their careers as students they competed to get into the best undergraduate programs, the best med schools and the best residency programs. Now, they are being asked to become part of a group, to become a team player and take a collaborative approach.”

With more than 20 years of experience in physician/hospital alignment and group practice management, Kirchner has seen 30-35 new clinicians join the Methodist Physician Group since he came on board in 2011, and he anticipates adding 2-5 more per month moving forward.

“The Methodist Physician Group is an employed group of highly qualified, board-certified doctors with multiple specialties in multiple locations,” he explained. “The overall goal is to always improve patient outcomes and enhance the quality of care. Committed to leading the way to better health in Northwest Indiana, Methodist Hospitals provide the expertise and technology necessary to offer the most advanced clinical care possible in a community-based hospital with tertiary services, so we are always looking to maintain an appropriate number and mix of physicians for the population we serve. To further expand the scope of services we provide, we also develop and maintain clinical affiliations or co-management agreements.”

With thriving hospital campuses in Gary and Merrillville, the Methodist Physician Group offers specialized consultative care including research and treatment with a comprehensive set of primary and secondary medical practitioners. Secondary medical care is provided by a physician who acts as a consultant at the request of your primary physician.

“When I made the decision to join the Methodist Physician Group two years ago, I literally started from nothing,” Jaroslaw Kuna, MD, Family Practice Physician with Methodist Physician Group in Crown Point, said. “I did my medical training in the Chicago area, and I lived in the southwest suburbs so I was looking for a good opportunity to start my own practice and build it close to home. The Crown Point office opened about a year before I came in so there was small base to start with.”

Because he wanted to spend more time focusing on his practice, Dr. Kuna made the decision to relocate to Crown Point and eliminate his two-plus hour daily commute.

“Things are going well, so I’m thinking I’d like to stay,” he said. “Methodist Hospital gives me quite a bit of help as far as the management part of being a private physician while allowing me some independence at the same time. The fact that they already have EPIC medical records is a great advantage. I can see all my patient records, all their labs and all the data right on my computer. When you’re a new graduate from residency training you don’t have a lot of financial resources, and that’s very costly. When you’re making rounds at the hospital before and after clinic time, it also allows you to just focus on patient care.”

A comprehensive medical record system, EPIC automates all aspects of the healthcare process – from registration to clinical documentation to measuring outcomes. It replaces a number of disparate clinical and financial networks with a single, unified information technology system.

“We’ve already seen how this technology helps us gain efficiencies, improving the patient experience and quality of care,” Kirchner added. “Before, if you had surgery, you would have several separate paper charts – one with the primary physician, one with the specialist/surgeon, one at the hospital and another for a skilled nursing or rehabilitation facility. Now, all your information is accessible in real-time to the entire team that is providing care.”

A private practice physician for more than two decades, internist Adolphus Anekwe, MD, joined the Methodist Physican Group last April.

“Methodist came to me many years ago, and I was not really interested at the time,” he said. “Dr. Mitchell brought me in to help out here in 1989, and I joined the group in 1992. He and Dr. Grant established the pride and joy here, and I took over when they both passed in 2002. Many new patients were added over the years, and this became a very busy practice. That’s when I took a second look at the prospect of joining Methodist and came to the conclusion that it would be a good thing for this practice.”

With hospital rounds often starting as early as 5am, Dr. Anekwe typically works at his practice until 6 or 7pm in the evening.

“Before I joined Methodist, I would then have 2-3 more hours of paperwork – filling out forms, paying bills, dealing with insurance and so on,” he added. “I have one of the largest practices in Gary, and now I can concentrate on what I like to do – take care of patients. I am perfectly happy, and I would do it again in a heartbeat.”

Another way Methodist Hospitals are working in partnership with physicians to broaden the scope of services they provide is through the development of co-management agreements.

Recently, IMA Endoscopy SurgiCenter, PC announced they signed a letter of intent to partner with Methodist. As part of the agreement, Methodist Hospitals will acquire the IMA Endoscopy SurgiCenter, where a group of six board certified gastroenterologist physicians, eight nursing and technical staff and three administrative staff will continue to work independently.

“We are happy to have this opportunity to improve our facility and equipment and more closely align with Methodist Hospitals,” Daniel Hurwich, MD, President of Digestive Medicine Associates, said. “This agreement provides the opportunity to deliver high quality, coordinated care with the focus on outstanding patient outcomes. Our co-management agreement is an arrangement where our physicians and Methodist Hospitals will share involvement in the daily operations of this service.”

Along with Dr. Hurwich, Peter Mavrelis, MD, John Mirro, MD, Omar Nehme, MD, Bassel Shughoury, MD and Kumar Venkat, MD are physicians on the Digestive Medicine Associates team.

“We are pleased and excited to partner with such an outstanding group of physicians and look forward to the excellent care delivery this brings to the communities we serve,” President and CEO of Methodist Hospitals Ian McFadden said. “This agreement will provide a mechanism by which the hospital and physicians will partner. Such partnerships will be a key element in the formation of accountable care organizations, which will represent an important component of care delivery in the future.”