The single life suits Dr. Keith Wilson.
Wilson runs one of the largest independent doctor groups in California, Costa Mesa-based Talbert Medical Group with projected revenue of more than $100 million this year.
“There’s no external corporate entities that skim off of our infrastructure and skim off of our revenue stream,” he said.
Doctor Buyout
It wasn’t always that way.
Talbert, a group of doctors that strikes deals with health insurers to see patients enrolled in their plans, used to be part of Birmingham, Ala.-based MedPartners Inc., once the nation’s largest operator of doctor groups.
By the late 1990s, MedPartners, now Caremark Rx Inc., was struggling and sold off its doctor groups to focus on its mail-order pharmacy business.
Wilson, an obstetrician and gynecologist, led a fight against the 1999 proposed sale of his group by MedPartners to Kali P. Chaudhuri, a controversial Riverside physician-businessman.
Instead, Wilson and about 120 other doctors bought Talbert.
“We bought ourselves back and (were) able to take a greater degree of responsibility and control of our destiny,” said Wilson, Talbert’s chief executive. “We’ve been able to increase shareholder value tremendously.”
Talbert runs nine clinics in Orange and Los Angeles counties with more than 80,000 patients and 700 employees.
And Talbert is looking to grow, either by combining with other practices or opening clinics, Wilson said.
Talbert pitches doctors on efficiency and providing better care to patients, he said.
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Fountain Valley clinic: one of nine |
“And if it’s a message they want to buy into, we strike a deal,” Wilson said.
Adding Sites
Talbert could add four sites by year’s end, he said.
The group has adapted in its seven years as a stand-alone operation, Wilson said.
Talbert has developed disease management, end-of-life and home healthcare programs in a bid to market itself to managed care plan operators.
The group also sells its “expertise” in managing medical groups to other doctor groups, Wilson said.
“Though times are tough, Talbert is doing well,” said Donald Crane, chief executive of the California Association of Physician Groups, a Los Angeles-based industry group.
Wilson is a member of the group’s executive committee.
Large groups such as Talbert link doctors together on operations, administration and technology, Crane said.
“Teams work better,” he said.
The group approach allows for less duplication, fewer errors and better care, according to Crane.
Talbert prides itself on having more entrepreneurial doctors, Wilson said.
“Physicians have been sort of reticent to engage in the business side of medicine, other than beyond a cottage industry,” Wilson said in an earlier Business Journal interview. “That reticence and unwillingness to engage has left them vulnerable to people who have deep pockets.”
The effects of managed care consolidation in Orange County, including December’s $9.2 billion buy of Cypress-based PacifiCare Health Systems Inc. by UnitedHealth Group Inc., haven’t been felt yet, Wilson said. Most employers already have locked up their insurance carriers for the year, he said.
UnitedHealth has pledged to support the “delegated model” of care provided by medical groups such as Talbert, Wilson said.
Under a delegated model, health plans pay a set amount of money per month for treatment. Doctors are on the hook for costs beyond that.
UnitedHealth also could use its buy of PacifiCare to roll out some of its preferred provider organization and fee-for-service plans here, Wilson said.
Talbert, which in the past year started its first advertising campaign, goes after PPO and fee-for-service with efficient billing and allowing patients to make same-day or next-day appointments with their doctors, Wilson said.
“In the fee-for-service market, patients want to be seen when they want to be seen and you have to be able to accommodate that,” he said.
Consolidation stands to pose a bigger threat to independent practitioner associations, according to Wilson. Practitioner associations are networks where doctors loosely band together but don’t share ownership in the group.
“UnitedHealth, Aetna and some of these national carriers are more in tune and accustomed to going directly to the providers for their network and not going to (associations),” he said. “They’d rather deal with an integrated entity.”
Going Digital
Talbert also has installed an electronic medical record system and Web site that allows patients to access their records.
Epic Systems Corp., a Verona, Wis.-based company whose customers include Kaiser Permanente, is Talbert’s supplier.
Talbert looked at NextGen, a unit of Irvine-based Quality Systems Inc., before deciding to go with Epic, Wilson said.
Talbert also has linked its system to ones at Orange Coast Memorial Medical Center in Fountain Valley and Anaheim Memorial Medical Center, Wilson said.
Orange Coast and Anaheim are two local facilities owned by Long Beach-based Memorial Health Services.
