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Hello, Patient Care Organizations: Physician Organizations in the New Era

March 14th, 2019

What’s in a name? Sometimes, limitations. A physicians’ organization (PO), for example, is the name given to organizations originally designed to help private practice physicians build and maintain an independent practice. Broadly speaking, the PO handled the foundational business aspects and insurance provider contracts of the practice, while the physicians tended to the needs of their patients and day-to-day operations. The role of POs in the past 10 years, however, has changed dramatically. Yes, we still negotiate contracts, trouble shoot patient registries and implement EHRs, but we also provide in-office care teams and care managers to support the 21st century model of medicine; and we introduce quality initiatives and measure their success.  We partner with our members to enhance patient care and its delivery.

Perhaps the first tangible evidence of change in the PO community goes back to 2005, when Blue Cross Blue Shield of Michigan introduced the Physician Group Incentive Program (PGIP). Recognizing the million+ adult and pediatric patient population that Michigan POs represent, PGIP (now called Value Partnerships) has had tremendous success in recent years harnessing the collective power of these organizations to introduce patient-centric primary care initiatives such as the Patient-Centered Medical Home designation, the High-Intensity Care Management program for the frail and elderly, and a variety of programs to prevent and/or manage chronic conditions. It is likely the outgrowth of our work with this Physician Organization-focused group that made me question our longstanding industry name.

Simply put, ‘Physicians Organization’ is not working for us anymore.  In my own organization, we first adopted the ‘big tent’ approach to accepting non-physicians when recognizing that behavioral health specialists play a key role in overall health and wellness. Accordingly, we welcomed them into our ranks in 2011, followed by chiropractic doctors in 2013. While the overwhelming majority of our members are still MDs and DOs, we are no longer a Physicians Organization. We are a Patient Care Organization (PCO) comprised of physicians, psychologists, limited license social workers, chiropractors and care teams all ultimately focused on delivering a variety of quality health services to the populations and communities we serve. For those POs out there doing the same, you’re not a PO anymore either – or won’t be for much longer once you see your efforts start to bear fruit.

Coincident with the introduction of Patient Care Organizations, there’s a movement afoot to establish patient forums and caregiver committees within primary care practices to encourage engagement among all stakeholders on patient care. Patient surveys – for those progressive practices that have done them before – have proven insufficient in impacting the care provided within the practice.  The impetus for these forums and committees is the call by certain regulatory agencies for practices that receive federal funds to create Patient and Family Advisory Councils (PFAC), with the goal of implementing needed changes based on patient and family recommendations. Considered an overreach by some observers – and perhaps they are right – PFACS are likely a positive development, at least in theory.  We must support and fine-tune them to measure their efficacy down the road.

The bottom line is that patients are at the heart of our organizations. Not physicians or other specialty health providers. I’d like to think we’ve always known that, and have always practiced that. But a name is important. And while it might take time for the renaming of Physicians Organization to Patient Care Organization to take root, I’m betting patients will be cheering us on. #PatientCareOrganization #HelloPCO

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