Many primary care practices have to merge with large hospital systems just to stay afloat.
But Paul Carlan, president and CEO of Valley Medical Group in western Massachusetts, said that trend drives up overall costs without improving patient care.
“Although hospitals are an incredibly important part of our healthcare system, often their interests don't align well with primary care practices,” he said. “Hospitals make revenue when they're busy, when they're filled, when they're performing lots of procedures.”
That’s why he said Valley Medical Group, an independent primary care practice with several western Mass locations, is partnering with a physician-owned company called Arches.
Based in Cambridge, Arches helps primary care providers negotiate a different kind of contract with private insurers, as well as Medicaid and Medicare. Those contracts – often known as “global payment” – generally pay per patient, not per service, which Carlan said promotes preventative care, more flexibility and lower expenses.
“Suddenly we can provide care over the telephone or through the portal without visits for simple problems that maybe don't need a visit,” he said, “which we think is a great benefit.”
While Valley Medical Group will have to share those savings with Arches, he said the practice still expects to come out ahead.
Eventually, Carlan said, this approach could help alleviate a widespread shortage of primary care providers by allowing organizations like Valley Medical to use the cost-savings on higher salaries. Most of the country, including western Massachusetts, faces a primary care crunch in part, experts say, because primary care providers are paid much less than specialists while also expected to take on many additional duties.
