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CORPORATE
MEDICINE

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ing all of the iterations of vbC is essential when aligning a prac- ization (like an ACO) can assist many physicians to remain inde-
tice to a level of risk. pendent and compete effectively with practices that were sold to a
Once CMS mandates that physicians will increasingly be paid on hospital or some other corporate type of entity.
a vbC model, the physician practice will need to have the appro- At the end of the day, physicians want to practice medicine, and
priate infrastructure in place to manage the risks and outcomes of they want to be able to make a good living at it; but the environment
their patient population. Some practices (smaller practices) will rely is changing. Adaptation to enable competition in this complex en-
on "corporations" (such as ACOs, MSOs, and IPAs) to assist them vironment is where the focus must be. Fighting the system is some-
in the infrastructure, while large practices may decide to develop times the answer, but you can be outspent and out-maneuvered. If
the infrastructure internally. Either way, there should be tolerance your solution is to fight, band together with other physicians (that
for corporations who help physician practices prosper, and at the is what TMA and bCMS are all about). That will increase the vol-
same time, not accuse them of practicing medicine for doing so. ume of the voice. The other answer for physicians is to learn better
For many physicians, an Accountable Care Organization (ACO) business practices. bigger-is-better seems to be the current theme.
may be the answer. Independent physicians getting paid for doing Adapt and innovate!
what they desire, i.e. improved patient outcomes, seems like a no-
brainer. However, as with most programs, hooking your existing Dr. Alan Preston is an experienced Chief Executive Officer with a demon-
practice to the right ACO is as important as deciding to participate strated history of working in the managed care and the healthcare industry. He
in such a program from the time of its foundaton. And since the has a Doctor of Science (Sc.D.) focused in Public Health, Health Services Re-
savings can depend upon the entire group of participating physi- search from Tulane University School of Public Health and Tropical Medicine.
cians, make sure you are in a network of like-minded physicians that He has been very involved in risk-sharing contracts, ACOs, Medicare Advan-
want to achieve the same results and who pay attention to the details tage including RAP scores, HEDIS, and STAR ratings which helps physicians
of how to accomplish the ultimate goal. Having an outside organ- and health plans alike in reducing MLR. Alan@Preston101.com.

26 San Antonio Medicine • October 2019