Strategies for Staying Independent in Primary Care Practice Texas Primary Care and Health Home Summit Austin, Texas April 6, 2018

Gregory M. Fuller, M.D. Independent Family Physician North Hills Family Medicine in Keller, Texas Board Member and Medical Director-West Region for Catalyst Health Network

Catalyst Health Network is a network of independent primary care physicians who have come together to provide coordinated, high quality care to our patients. Remain independent while enjoying the services and structure needed to be successful in the new, value-based world of healthcare. Catalyzing The Transformation Of Health and Well Being In Our Communities

515+ Physicians 99 Locations

Factors that are affecting small independent physician practices : Health information technology requirements Collecting and report quality and outcomes data Scaling up to participate in an Accountable Care Organizations (ACO) Participating in Value-based purchasing Securing higher payment rates Choice or threat to sell to hospital system Providing Care coordination and Case management

Strategies for Staying Independent: Focus on Value-Quadruple Aim—Improve patient experience, improve the health, lower cost, improve the well-being of healthcare providers Clinical integration --ACO --Clinically integrated network Make sure that Physicians make up a majority of the leadership and that Primary Care physicians makes up a majority of that leadership. GET THE DATA Form a multispecialty group Improve revenue --better contracts --shared savings --ancillary services --use of PAs, NPs, health coaches --expanded hours-early morning, evening, weekends --home visits --Telemedicine

Strategies for Staying Independent: 5. Direct Primary Care Concierge practice Cash only business