Super-Group Physician Practices Offer Benefits, But Raise Concerns

The news is “disheartening,” a disappointed Dr. Schweitz reported in a follow-up telephone conversation. Although he was hopeful that something could be done to salvage the efforts, the chance is likely remote, he said.

The failed attempt to bring the South Florida group together illustrates what may be a resistance among rheumatologists to hop on the super group bandwagon, trend or not. “Rheumatology is behind the curve,” said Dr. Feldman.

“There aren’t many super groups in the rheumatology specialty,” he said. “So there isn’t much of a track record. But many other subspecialties are following the trend.”

Dr. Moldawer

Dr. Moldawer, an orthopedic spine surgeon, described how his super group pooled together more than 40 providers over time to form a business that now has more bargaining power and is big enough to branch out to other areas that create income outside any individual physician practice.

“We have found it to be enormously helpful to have a practice that’s large enough to allow us to take advantage of ancillary income streams that would be otherwise impossible in a small practice environment,” said Dr. Moldawer.

Four ancillary income streams come from ambulatory surgery centers, MRI centers, physical therapy and durable medical equipment. In some cases, they have become as profitable as the surgical practices themselves.

Dr. Jenkins

Relationship Building

Panel member Dr. James Jenkins, PhD, MPH, a managing partner of rheumRx, paints a picture of the current practice model as one in which health insurance representatives have the upper hand when negotiating payment terms. He shows a slide of randomly placed blue circles representing numerous rheumatologists who operate independently in the Los Angeles area.

There’s no coordination between the practices. There are a lot of solo physicians with no integration and no support system. As a result, it becomes easier for an insurance company network representative to approach individual doctors and say, “If you don’t sign a contract with us, someone else will,” said Dr. Jenkins.

Super groups are one way for rheumatologists to adapt, survive &, hopefully, thrive in the changing world of medical care delivery & how it’s financed.

To convince insurance payers to be more responsive, physicians have to have ongoing discussions with them regarding “what they are paying you and what it costs to deliver care to your patients,” said Dr. Jenkins, and today’s medical practices need a structural support that can facilitate negotiations. Super groups of physicians have stronger footing to negotiate rates paid for medical care, how often and under what circumstances, he said.