United Physicians: Dr. Steven Grant, President & CEO

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In Southeast Michigan more than 2,000 doctors are shareholders of United Physicians (UP), the largest independent physician organization in the state, and only 1 of 3 POs in the country to have dual NCQA certification. “We facilitate contracting for physicians. We do medical management. We do volume purchasing. We do anything we can to take care of our physicians in terms of increasing the quality of care being delivered. Also, we assist them with the business side of the practice, including improving revenue and expense management.” says Dr. Steven Grant, President and CEO.

United Physicians began as a merger of two physician groups that now make up its body. Premier Physicians Network (PPN), the HMO contracting entity, is now a wholly owned subsidiary of the parent organization, UP.  Member physicians have staff privileges at hospitals throughout the region.

Health Information Exchange

Currently, one of the biggest initiatives for United Physicians is the ongoing creation, adaptation, and expansion of an electronic portal where physicians can gain the benefits of electronic medical records without taking on the prohibitively high costs. “EMR purchases, especially in private offices, have been stalled for the past few years,” says Grant. “We actively pursued EMR adoption 5 years ago, experienced the frustration, and had to take a different tack for our physician shareholders.”

They began their physician-driven electronic portal project with a prescription application. They now have approximately 800 physicians using the application and have already issued more than 1.4 million prescriptions. “Once we have doctors online with prescribing, there are other applications that they can move to,” says Grant.

Through the United Physicians electronic portal, member doctors can use any PC with internet access to write and transmit prescriptions to pharmacies instantly. The program provides them with alerts to patient allergies, potential drug interactions, and insurance plan eligibility and compliance procedures. In short, the program makes tracking a patient’s medication history much easier. In the first one million prescriptions issued by United Physicians members, approximately 7% were changed due to drug-to-drug interactions or patient allergy notifications caught by the system. This helps physicians reduce the number of illnesses, hospitalizations, and even potential deaths from medication interactions and mistakes.

The group is now in the process of adding a patient registry application to the portal so that doctors can track chronic diseases such as diabetes, asthma, congestive heart failure, and coronary artery disease.

“We have close to 2,000 doctors signed up for the base portal,” says Grant. “Not all of them are using it in the most extensive way, but the fact is that they are being introduced to it and hopefully we are going to get a lot more takers. We have four other physician organizations that are signed on to be a part of this project. We are probably going to have close to 4,000 — possibly 5,000 — doctors, using this tool in the not-too-distant future.”

The end goal, of course, is to create a large base of physicians who are tied together electronically. When a patient visits one doctor, all the lab results, for instance, will be available through the portal so that another doctor a few days later doesn’t need to repeat tests or rely on the patient’s memory alone for procedures, results, and prescriptions.

Helping Physicians Meet Challenges

The major emphasis for a group like United Physicians, of course, is to help its physician members achieve maximum efficiency. “Physicians are being challenged on a daily basis, especially primary care physicians,” says Grant. “As the reimbursement for physicians continues at unsustainable rates, we have to help them find ways to increase their revenue or decrease their expenses. It’s been a challenge for years and it continues to be a challenge.”

“We are constantly trying to keep the physicians engaged and show them what they need to do to get withhold and incentive money back,” says Grant. Health information technology is a way to increase the quality and efficiency, and improve the bottom line, “but a lot of doctors are still skeptical,” he says. “We have to continue to weave the tools into their daily routines and convince them that this is the future.”

The group subsidizes its members heavily, especially during the first year on the portal.  “If we go into an office and they need computers, a high-speed line, router, WiFi or whatever, we pretty much pay for that. We significantly discount the product in terms of whatever software licenses they need, hardware, etc.,” says Grant.

The benefits speak for themselves. Reduced mistakes in terms of misreading of handwriting and prompts regarding drug interactions and allergies are self-evident. “But the office staff, they love it,” says Grant. “It frees them up to do other things. They don’t spend their day “looking for charts,” calling pharmacies, waiting to speak with the pharmacist, or getting calls from the pharmacy, especially at the end of a day.”

“What we do is going to start impacting the cost of healthcare,” says Grant. “We [as a nation] are going to spend close to $2.5 trillion in healthcare this year and most experts estimate as much as $500, maybe $600 billion, of that is waste and duplication. If a doctor is using these technology tools appropriately … we’ll be able to cut down on some of that waste.”

A Voice for Independent Physicians

Grant says that organizations like United Physicians are important for more than just sharing costs and gaining ground where being a part of a larger entity might be beneficial. “Doctors do not have much of a voice when it comes to a lot of major issues,” says Grant.  “The hospitals always have someone at the table. They always have a very strong lobbying organization available whereas there really isn’t anybody who speaks for the independent physicians in a meaningful way… We are here to make sure that the physician can keep their head above water, whether it is in contracting or being informed of the incentive programs so they can capture the money and not leave it on the table.”

“This is also extremely important in terms of health information technology. An independent office would be very hard pressed to do this type of thing on their own. We provide the implementation and support team that goes out and holds their hand so they can use this technology effectively. We’re out there on the front lines providing services for independent physicians that they otherwise wouldn’t have.”

-by Tracy Million Simmons

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