The Successful Primary Practice Terry Cunningham, DBA, MHA Chief Operating Officer Palmetto Primary Care Physicians, LLC

Who is Palmetto Primary Care Physicians?

Leaders in Primary Care Our History: Early 90s, managed care HMO’s were being formed on the West Coast of the US. Physicians had obvious concerns that insurance companies and government controls of healthcare delivery systems would expand to the East. The concern of managed care led 3 primary care groups in Dorchester County (SC) to begin discussions over a “clinic without walls“ business model. The doctors met frequently with the idea of forming a single group that would mean better ability to fight managed care. Palmetto Primary Care Physicians formed in January 1997. Early offers by hospitals to purchase the group would be entertained but always declined by the physicians.   The desire was to remain independent!

Leaders in Primary Care Our Present: Today PPCP has grown to serve over 200,000 patients throughout 33 primary and specialty care offices in 5 counties. We employ over 575 clinical and non-clinical staff members, including 46 physicians and 54 mid-levels. Our services have grown to include: Neurology Endocrinology Gastroenterology Psychology Urgent Care Center Lab Imaging NEW!

Leaders in Primary Care PPCP Market:

Leaders in Primary Care Our Future: Became an Accountable Care Organization (ACO) in 2016. This will move us into the future by: Improving quality while reducing costs Incentivizing us to create stronger partnerships with community health organizations towards a common goal Strengthen our competency in team-based patient care

Leaders in Primary Care Our Future: Launch a Management Service Organization (AVANT MSO) Providing an “open menu” of services, available on an “al la carte” basis Empowering small offices to access needed services while remaining independent Allowing independent physicians to “digest small bites” in the movement toward integration with a larger group of physicians Enabling Clinically Integrated Networks to share a unified electronic medical record, without unified employment relationships

What does Primary Care look like today?

Understanding Primary Care Today Legislation has created more demand for primary care services (think ObamaCare), but less primary care physicians are entering the market – creating a high demand, but lack of supply Increased demand for data and performance based metrics are demanding more of the physician’s time while they are with the patient (ie. Meaningful Use data) Industry is ‘transitioning’ from fee for service to fee for value. Most practices are moving into team focused patient care, however, not seeing the full monetary benefits of it yet…and won’t for a few years! Healthcare is still largely fragmented when it comes to delivery of care. Independent practices are required to collaborate with other healthcare providers in the community in order to provide the communication and level of care expected by patients.

Understanding Primary Care Today Patients are now CONSUMERS, not just patients!

The ‘Mechanics’ of Primary Care

Imaging (including Mammo) Process Flow Primary Care Urgent Care Center Gastroenterology Care Coordination Psychiatry Lab Imaging (including Mammo) Neurology

Advanced Practitioner (NP/PA) Ratio Rule of thumb 3 AP’s for 1 physician In order to improve efficiency, practices can have their advanced practitioners see patients who need basic preventative care and those who need to be seen for straight-forward acute illnesses or uncomplicated chronic conditions. This frees up the physicians to see the more complicated patients.

Care Coordination Leadership

Care Coordination Examples:

The Future of Primary Care

The Future of Primary Care Patient-centered care Improving outcomes for patients with chronic illnesses Focus is on reducing costs (minimizing re-admissions to ER through preventative care, reducing long term hospitalizations) Strengthen the physician-patient relationship Tele-Medicine Reimbursements focused on Patient Satisfaction  

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