Beacon IPA Intro 2010


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  • It goes without saying that physicians are worried about the state of healthcare today. But frankly as altruistic as we are, what we are most worried about is our own future.  Healthcare reform, changes in reimbursement, rising costs and worsening administrative burden are all wearing doctors down to the point of selling out or consolidating for safety and security. That’s why we put together Beacon IPA. Beacon is a Clinically Integrated IPA. Here we chose a clinically integrated model to get our members on a shared clinical electronic platform and harness the power of this data for our benefit. We chose the IPA structure for several reasons, but basically it allows us to come together without giving up our autonomy or corporate structures... with more freedom and flexibility than a single group. Our goal is to unite the docs and position ourselves to take advantage of the changes in healthcare reform. We intend to remain independent, create value.... and more than just survive... we intend to thrive.
  • Nevertheless, this is how most physicians feel
  • If I could sum it up... the biggest fear is the fear of the UNKNOWN
  • Some of the more specific reasons.... to name a few
  • So, is this the death of private practice?
  • Private practitioners however have choices.... 1- stay the course alone 2- Join:      Single specialty practice      Multi-specialty group practice      Hospital/ Health system      Traditional IPA OR....
  • This is our answer....
  • IPA= independent practice association... the "middle man".. contracting with the healthcare providers and the insurance companies
  • Many IPAs are out there... but, we believe ours stands apart..
  • Clinical Integration Is an active and ongoing program to evaluate and modify practice patterns of the network's physician participants and create a high degree of interdependence and cooperation among the physicians to ensure quality and provide value to our patients.. and the payors
  • Marriage of two concepts  IPA + Clinical Integration = BIPA
  • Human capital and specifically the physicians we bring into our network is VITAL for the success of BIPA. Building and growing our physician network is the #1 Priority
  • Although we want all the specialists to be represented our main target are the PCPs...  We desire >50% PCPs and feel that a strong primary care base is the key to our success.  
  • We are already actively engaged with the managed care plans and have had very productive discussions. Tangible results of these discussions are anticipated in the following weeks to months . We believe in order to maintain a competitive balance there is an opportunity for a physician led initiative in this geographic area. With this understanding we anticipate the plans will help to incentive our venture.
  • EMR is here, and we need to embrace it... The government has put into the stimulus bill an incentive of $44,000 PER PHYSICIAN for those meeting meaningful use... We intend to support the implementation of the EMR and through our partners we will gaurentee meaningful use
  • Ultimately as a Clinically Integrated IPA, we will need to link our members electronically  Although BIPA has an exclusive EMR offering, practices DO NOT need to be on the same EMRs to join our network and clinically integrate with us. We intend to create our own HIE - health information exchange and harness the power of our clinical data to create and demonstrate our value.
  • A Clinically Integrated IPA is a vehicle to become an ACO. This is one of our goals... An ACO is.... an accountable care organization. An ACO  is a provider group that accepts responsibility for cost and quality of care delivered to a specific patient population.
  • See Daniel Pink's book-  DRIVE  The Surprising Truth About What Motivates Us Autonomy Purpose Mastery There is great utility in remaining independent and together we can succeed.
  • Increased Income Opportunities: EMR Meaningful use incentive stimulus bonus $44,000 / physician Managed care contracting activities  Enhanced rates pay for reporting bonuses Medical home opportunities ACO shared savings bonuses
  • Cost- can join free as a participating provider Time- variable, up to you depending upon how engaged you choose to be in BIPA.
  • Equity Membership : nominal fee (which will be increasing and perhaps completely capped in the near future). Allows a member of the group a seat on the Steering Committee and an increased say in the direction of BIPA as we move forward together shaping the delivery of healthcare on long island and Queens. Participating Providers : join with no upfront cost. Agree to clinically integrate, and can enjoy all the benefits of Beacon including the managed care contracting activities and clinical initiatives. 
  • 516-365-5570 [email_address]
  • Beacon IPA Intro 2010

    1. 1. Beacon IPA Simon Prince Supporting Today, Preparing for Tomorrow
    2. 2. Physicians Today
    3. 4. Why Are Docs So Worried? <ul><ul><li>Healthcare Reform </li></ul></ul><ul><ul><li>Changes in reimbursement </li></ul></ul><ul><ul><li>Rising Costs </li></ul></ul><ul><ul><li>Increased Administrative Burden </li></ul></ul><ul><ul><li>Shrinking Referral Base </li></ul></ul><ul><li>  </li></ul>
    5. 7. Clinically Integrated IPA
    6. 8. What is an IPA? Insurance companies Health Care Providers
    7. 10. Clinical Integration
    8. 11. IPA Clinical Integration
    9. 12. Why Clinically Integrate? To create a vehicle to support, promote and market our efforts to improve the value we provide to our patients ... and the payors
    10. 13.   BIPA's Strategic Priorities
    11. 14. Build a Strong Physician Network
    12. 15. <ul><li>Primary Care Physicians </li></ul>
    13. 16. Contracting Engaging the Payors
    14. 17. Optimize Adoption and Implementation of EMR
    15. 18.   Beacon Health Information Exchange B H I E
    16. 19.  
    17. 20. Why Participate in BIPA?
    18. 21. Why Participate in BIPA? <ul><ul><li>AUTONOMY </li></ul></ul><ul><ul><ul><li>Maintain Independence </li></ul></ul></ul><ul><ul><ul><li>Controlled by Physicians </li></ul></ul></ul><ul><ul><li>PURPOSE </li></ul></ul><ul><ul><ul><li>Importance / Relevance </li></ul></ul></ul><ul><ul><ul><li>Physician led start-up initiative </li></ul></ul></ul>
    19. 22. Why Participate in BIPA? <ul><ul><li>EMR / EHR and IT support </li></ul></ul><ul><ul><li>Collaborating/ Network w Colleagues </li></ul></ul><ul><ul><li>Prepare for Payment Reform  </li></ul></ul><ul><ul><li>Economies of Scale </li></ul></ul><ul><ul><li>Increased Income </li></ul></ul><ul><ul><li>Administrative Services </li></ul></ul><ul><ul><li>Low Barriers to Entry and Easy Exit </li></ul></ul>
    20. 23. Are There Reasons  NOT to Join BIPA?
    21. 24. Ways to Join BIPA Equity Membership             Participating Provider  
    22. 26. <ul><li>  </li></ul>NEXT STEPS JOIN US TODAY! [email_address]