“They are competing with each other, and us, in many ways,” he says of independent physicians. “And it’s tough to get them to actually believe in something other than their day-to-day survival.”
Hillman started with transparency. Summa chose as initial partners the top five largest primary care groups in the area that were offering the best quality and good leadership, and brought them in immediately to explain Summa’s vision and the critical nature of their participation in the ACO. The goal was to align providers along the continuum of care to systematically anticipate and address the health needs of the population they serve.
With representatives from each group, the ACO board set up four committees to help with project management: an IT group, a care model group, a finance group, and a physician network group.
Summa invested in call centers. It invested in IT with the idea that it would yield not just an EMR for the doctors in the ACO, but would offer tools that help identify patient populations. But the affiliated physicians, he says, also needed “skin in the game” to galvanize their investment in the ACO’s goals of achieving better and less costly patient care.
“This is not all funded by Summa,” Hillman says. “We had to develop a way where physicians really learn how to take risk—and not just insurance risk.”
As their contribution, affiliated doctors in the ACO give a small percentage of their fee-for-service revenue to defray the administrative costs of the ACO.
“Convincing these independent physicians to commit to it has been a challenging thing,” he says, “but it has to be done because the most dangerous part of healthcare is the handoffs.”