Orange County’s larger medical groups say they’ve already embraced aspects of healthcare reform, even if its fate is up in the air in Washington.
“We haven’t waited for the rest of the country to catch up,” said Keith Wilson, chief executive of Costa Mesa-based Talbert Medical Group, a doctor-owned medical group. “We’re years ahead.”
Doctors at medical groups here contend that the crux of proposed healthcare reform—more affordable coverage for all, better care and increased patient safety—is what they’ve promoted for years.
“We’ve always been focused on the quality of care,” said Bart Asner, chief executive of Monarch HealthCare, an Irvine-based medical group.
‘Pay for Performance’
Monarch, which has about 168,000 patients and 1,800 doctors, takes part in what’s called a “pay for performance” program that offers financial rewards if medical groups meet standards, such as patients getting well sooner, according to Asner.
Preventative care, a key part of healthcare reform, is a focus, local doctors said.
Congress now is encouraging preventative care through accountable care organizations, which have been included in the healthcare bills passed by the House and Senate.
An accountable care organization is a group of doctors and hospitals that would get paid under Medicare for keeping patient costs down, which often is accomplished with preventative care.
The more that doctors and hospitals keep costs down and meet care standards, the more Medicare would pay them.
Currently, doctors and hospitals get increasing payments from Medicare when services and patient admissions go up.
The accountable care healthcare model is similar to how many local medical groups operate today, Wilson said.
But this model has been slow to take hold in other parts of the country, he said.
“It was kind of exciting to see that the rest of the country was moving in that direction,” said Wilson, who recently was named chairman of the California Association of Physician Groups, a Sacramento-based professional group.
Electronic Records
Electronic medical records, another reform push, is common among local medical groups, according to doctors.
Monarch, Newport Beach’s Greater Newport Physicians, Tustin-based Bristol Park Medical Group and Talbert all have put money into electronic medical records.
Electronic records make it easier to track the sickest patients as well as efficiently coordinate all forms of care, Monarch’s Asner said.
The move to electronic records has proven a boon to software providers.
Monarch, Greater Newport and Bristol Park all use NextGen software, made by Irvine-based Quality Systems Inc., which develops software that helps doctors and dentists manage their practices.
Talbert, which has 10 locations in Orange and Los Angeles counties and about 120 employed doctors, uses software made by Epic Software Corp., a Milwaukee-based competitor of Quality’s.
Epic also makes Kaiser Permanente’s electronic medical records software.
Monarch, which cares for some 168,000 OC patients and has about 1,800 affiliated doctors, has spent “millions of dollars” to install an electronic records system in its offices, Asner said.
“Because we’re not publicly held, we can make investments in our infrastructure,” he said. “We’re only accountable to ourselves.”
He said he expects Monarch’s revenue to be in the nine-figure range this year.
Greater Newport’s has had NextGen electronic records since 2006 and plans to further expand to coordinate with doctors and its affiliated hospital, Newport Beach’s Hoag Memorial Hospital Presbyterian, said Diane Laird, Greater Newport’s chief executive.
Greater Newport, which started in 1985, has 500 affiliated doctors and some 100,000 patients under its care.
Medicare
But local medical groups also have their beef with Washington’s healthcare reform proposals.
Group practices could see revenue drop if Congress passes a proposal to cut funding for Medicare Advantage plans as a way to finance healthcare reform, according to Wilson.
“California, and specifically Orange County, has a higher concentration of Medicare Advan-tage than the rest of the country,” Wilson said.
Medicare Advantage plans provide coverage for seniors under the federal Medicare plan but are provided by private insurers.
Almost a quarter of the patients Talbert cares for have Medicare Advantage coverage, Wilson said.
Monarch has about 28,000 Medicare enrollees among its patient ranks.
Medical groups aren’t worried yet.
When the Senate lost its Democratic supermajority with Republican Scott Brown’s January win in Massachusetts, it put some doubt on the viability of a speedy healthcare bill.
“I hope healthcare reform doesn’t just fall flat on its face,” Wilson said.
