The University of Rochester Medical Center's fledgling accountable care network has hired veteran area health care executive Mark Cronin as its chief operating officer.
Cronin started in the position last month at Accountable Health Partners IPA LLC, interim CEO Robert McCann M.D. said this week.
The URMC physician association is one of three such groups vying to enlist privately practicing primary care doctors in the area.
Such groups promise to figure prominently as vehicles for doctors to collect fees under new payment models that private and government third-party payers are exploring as the Patient Protection and Affordable Care Act's initiatives advance.
Rochester General Health System and Excellus BlueCross BlueShield also are setting up similar networks and wooing physicians to fill their membership rolls. It is not clear how easy it will be for doctors to belong to networks.
Cronin steps into the position in an early stage of the URMC organization's development.
Chartered in late March, AHP is working to build the sophisticated information technology infrastructure that such groups will need to meet the cost and quality tracking requirements expected to govern how doctors are paid in the future.
Cronin most recently served as CEO of University Cardiovascular Associates, a 130-worker, $17 million private specialist group in this area. He previously was the American Cancer Society's Eastern Division vice president and headed its Rochester office. He also worked for the Rochester Individual Practice Association, for Empire BlueCross BlueShield in Albany and for the Rochester-based Preferred Care HMO before it was taken over by Schenectady-based MVP Health Care.
"I see the next six to 18 months as a building project," Cronin said.
Over that span, AHP will concentrate on putting together information technology capable of the fine-grained analysis needed to track the quality and cost of care provided by its members.
McCann also said the development of an IT system is a top priority for the URMC physician group, ranking with physician recruitment in importance.
Building a system that would knit together a dozen or more differing electronic medical records systems and be capable of producing good data is among the organization's greatest challenges, McCann said.
Enlisting a pool of private primary care doctors matters to accountable care networks for two reasons: Most see the kind of preventive care that is best dispensed by primary care providers as critical to achieving the cost reduction and quality results the new payment models call for. Maintaining a network of primary care doctors sufficient to direct referrals to a health system's surgeons and specialists also is key to maintaining enough market share, McCann said.
U.S. primary care doctors have long and increasingly grumbled that under the current fee-for-service payment model, which rewards quantity of care but takes scant notice of quality, their pay is comparatively low, their hours are long and often they lack autonomy.
Now they find themselves belles of the ball.
McCann and other URMC officials-as well as their counterparts at RGHS and Excellus officials including the insurer's CEO, Christopher Booth-have been meeting with area private practice doctors to pitch the merits of their respective accountable care organizations.
With 200 new members having joined its core group of some 1,000 URMC-employed doctors, AHP is approximately one-third of the way toward its stated goal of recruiting 500 private practice doctors, McCann said.
Nancy Adams, executive director of the Monroe County Medical Society, said her organization is neither recommending any accountable care groups nor warning its membership away from any. The society includes most of the area's doctors in private practice.
Still, she believes, as government and private third-party payers adopt new physician reimbursement models, private practice doctors will be hard-pressed not to join at least one such organization. And to keep the society's members up to date, she has attended accountable care network recruitment drives.
"There are some who are saying, 'I'm going to need to belong, and I might as well get it over with,' but I think a lot of the doctors are taking a wait-and-see attitude," Adams said.
One reason for caution: The rules governing the organizations could still be fluid.
McCann-Highland Hospital's chief of medicine and a practicing gerontologist-and an interim board of directors are guiding AHP until September, when its members are slated to elect people for those posts.
While both URMC and RGHS-the region's dominant provider organizations-are saying they do not intend their accountable care networks to be exclusive, Adams said, many doctors are not sure how easy it might be to join more than one.
The health systems' assurances notwithstanding, she said, limited provider panels that keep care within a single system as much as possible are expected to be a key feature of the provider organizations that emerge as reform evolves. Doctors who join a network might find themselves wedded to that network's parent system.
An Excellus spokesman said in a recent interview that the rules for its nascent accountable care network would be developed and codified only after the insurance company sought input from private practice doctors over the next few months, but he also characterized the nameless group as being for doctors who do not want to join any other organization.
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