By Dr. Keith Fernandez
Senior Physician Executive, Privia Health
The American health system is broken. In fact, it has really functioned more as a payment system and not a health system focused on the needs of people that use it. The “success” of this system has resulted in a burgeoning of the US healthcare spending to 17.5% of our Gross Domestic Product, with so far only average results in health outcomes. That is 3-4 times the cost of most other countries with modern economies. The system does not work and I believe physicians are not only the right people to fix it but that they must lead the effort.
Accountable Care Organizations (ACOs) are a new model of care that organize providers, physicians, payers and sometimes even patients, to improve patient outcomes and control costs. This provides a platform for physicians to both lead and participate in reshaping our healthcare system. This new model of healthcare is a huge disruption in medical practice and it is difficult for physicians, hospitals and other care providers to make the transition. Many physicians are also skeptical that this change will provide appropriate compensation for the sometimes demanding and time consuming work it entails. Not an unreasonable thought as 70% of ACOs didn’t receive shared savings last year according to the Centers for Medicare and Medicaid Services (CMS).
Of course, 30% of ACOs did generate shared savings and Privia ranked among the best. In fact, CMS has recently identified a few organizations that are leading the change to accountable care and value-based medicine. Privia was in the top 7% of all ACOs in the Medicare Shared Savings Program for the 2015 performance year, after achieving over $12.8 million in cost savings while maintaining a 98% quality score, which means lower costs, improved quality of care and payment for improved outcomes!
Unlike most organizations, Privia Medical Group is purpose built by physicians and for physicians to succeed in value-based accountable care. Our mission is to provide the best patient care and reduce unnecessary expenses, while improving the ability of physicians to succeed and be happy. In pursuing this mission, we have been able to achieve shared savings two years in a row. Majority of the reason being that the physicians who are leading this effort understand their patients and local healthcare needs better than anyone. I joined Privia because it puts doctors back in control of healthcare and our promise is to change healthcare to what it ought to be.
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