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Managed Care Information Center  
1913 Atlantic Ave., Suite 200
Manasquan, NJ  08736
(732) 292-1100
fax: (732) 292-1111


MCIC Press Release

June 21, 2010


Why Physician Organizations
Are Now Getting All the Attention

MANASQUAN, NJ --  June 21, 2010: A new special report, "Why Physician Organizations Are Now Getting All the Attention," has been produced by the Managed Care Information Center.

There is much interest today in physician hospital organizations (PHOs) and independent practice associations (IPAs) with good reason.

Many of the physician organizations are growing bigger through consolidation and are now given the respect they deserve. With their size, the physician organizations can and are becoming the driving force in helping their physician members adopt electronic health or medical records.

Another factor is that incentive programs for EHR are adoption growing.

Impact of the Federal Stimulus Funds

And, the recent economic stimulus package funding of approximately $19 billion in money dedicated to health IT catches the attention. Also, there will be Medicare and Medicaid incentives over five years to assist physicians in purchasing health IT systems.

Those billions are expected to enable such physician organizations as PHOs and IPAs to help build out their member physicians electronic health records.

"Availability of government stimulus money, combined with hospitals being allowed to finance portions of physicians' electronic medical record systems, could make EMR adoption a veritable bargain," said one news report.

The Funding Available to Physicians and Vendors Can Help

Doctors can get a maximum of $44,000 in funds from the federal economic stimulus package for adopting a certified EMR system that meets the government's "meaningful use" standards.

How much physicians get in stimulus funds will be based on the percentage of their practice that is made up of Medicare or Medicaid patients.

Momentum is building behind incentives for physicians to adopt  EHRs in their medical practices, according to research by the Certification Commission for Healthcare Information Technology (CCHIT).

In a recent search for programs that have sprung up to subsidize physician adoption of health information technology over the past two years, CCHIT said it found 90 initiatives in the public and private sectors. The 90 programs in the CCHIT Incentive Index catalog represent at least $700 million in potential funding for EHR software and implementation costs.

CCHIT said The Bridges to Excellence offers bonuses for use of CCHIT-certified EHRs, according to the CCHIT. Most recently, Bridges to Excellence has chosen to deem use of a CCHIT-certified EHR as sufficient qualification to demonstrate use of electronic information at levels that put physicians in line for monetary bonuses as a reward for superior management of patients with chronic ailments.

In addition health plans like Blue Cross Blue Shield of Massachusetts are requiring physicians who prescribe medications to electronically prescribe to qualify for any of its physician incentive programs effective Jan. 1, 2011.

The health plan said it is introducing this initiative in an effort to continuously improve the quality, affordability and efficiency of care for its members. The new requirement applies to both primary care physicians and specialists. Currently, 99 percent of primary care physicians in the HMO Blue Network and 78 percent of specialists participate in BCBSMA incentive plans.

How to Qualify for the Incentive Payments

To be "qualified" for incentive payments, EHR technology must have (a) the capability to include patient demographic and clinical health information, and (b) the capacity to (i) support order entry, (ii) provide decision support, (iii) capture and query information relevant to health care quality, and (iv) exchange electronic health information with and integrate electronic health information from other sources, according to Stephanie B. Vasconcellos and Amir Azaran of the Neal Gerber Eisenberg Health Law firm.

PHOs, IPAs, management service organizations (MSOs) and physician practice management companies (PPMCs) have been closely tracked and researched by the Managed Care Information Center in connection with the production of the National Directory of Physician Organizations Database on CD-ROM.

The database also contains business information on management services organizations and practice management companies.

The database on CD-ROM includes PHOs, IPAs, HMO-model IPAs, MSOs and PPMCs. IPAs or PHOs affiliated with or participating hospitals and health systems are identified as such. We provide numbers of primary care and specialist physicians in the organization

The Managed Care Information Center team researches and compiles the information directly.

The National Directory of Physician Organizations Database on CD-Rom profiles more than 2,200 physician organizations. Listings include: PHOs, IPAs, HMO-model IPAs, MSOs and PPMCs.

Every physician organization operates differently. The National Directory of Physician Organizations Database on CD-Rom details which organizations have responsibilities for contract negotiations, utilization, marketing, credentialing, quality management and claims because it varies from one organization to the next.

For more information on The National Directory of Physician Organizations Database on CD-Rom, visit:
http://www.healthresourcesonline.com/managed_care/23poe.htm

Address: The Managed Care Information Center, 1913 Atlantic Ave., Ste. 200, Manasquan, NJ 08736; (732) 292-1100, www.themcic.com.