Doctors, MWHC Team Up To Tame Expenses By Enhancing Efficiency Of Services Rendered
Mary Washington Healthcare and area doctors have joined together in a new
program to improve healthcare and lower costs.
The Mary Washington Health Alliance, as it’s called, is helping MWHC
and about 400 independent doctors coordinate patient care, share best
practices and provide follow-up for high-risk patients.
“Its goal is to respond to changes in the health care industry,”
said Travis Turner, the alliance’s vice president of clinical integration.
“How better to do that than partner the health care system and local
Begun on a limited basis last year, the alliance is already having an impact.
The total cost of care for the 50,000 people that it serves—employees
in its self-insured plan and Medicare patients—has decreased 3 to
4 percent so far this year compared with 2014, when it was first implemented,
Meanwhile, total health care spending nationwide has increased 4.4 percent
this year, according to the Peterson–Kaiser Health System Tracker.
Mary Washington Health Alliance is what’s known as an Accountable
Care Organization, a concept that’s springing up nationwide. So
far, it is the only one in the Fredericksburg area.
“Physicians want to do one thing primarily, and that’s to take
the best care of their patient as they can,” said Dr. Thomas O.
Janus, who chairs the alliance’s board and is the founder of Rappahannock
Their dilemma, he said, has been that doctors treating the same patient
haven’t had an easy way to share information about the medications,
labs and other tests that they’ve ordered. That can help improve
treatment and avoid the additional cost of duplicate tests.
“We need a way to get real information to people,” Janus said.
“This allows us to have a true health information exchange. If I
see a patient today, by the time he leaves, all the information is available
to his other doctors. That would never happen without an ACO.”
To accomplish this, the alliance is asking physicians to use the same electronic
health information system. While the majority already use electronic records,
the programs aren’t always compatible.
This year, 15 doctors groups switched to a system owned by a subsidiary
of MWHC. Another 15 will have changed over by the end of 2016.
“Hopefully, by the end of the third year the entire alliance will
be up and running,” Janus said.
The alliance also provides members with access to a library of best-care
practices, because technology and health care are evolving so rapidly
that it’s difficult to keep up, Janus said.
Locally, an allergist and immunologist have teamed up to develop a protocol
for dealing with asthma, which can help prevent a patient’s condition
from getting serious enough to see a specialist, said Dr. Jeffrey Frazier,
a radiologist who serves on the board of Pinnacle Health, a local physician’s
health organization similar to the alliance.
“We’re trying to get the right level of care to the right physicians
at the right time so they can treat things more appropriately,” he said.
In addition, there is now a business roundtable where people who manage
practices can share information about such things as the latest federal
health care regulations, Frazier said.
Care provided by alliance participants doesn’t end when a high-risk
patient leaves a doctor’s office or the hospital. Coordinators check
to make sure they follow their doctor’s orders. If a patient can’t
afford a medication, for example, the coordinator might be able to get
them samples, a discount or have their prescription switched to a generic, he said.
Steps such as these can help prevent the patient from being readmitted
to the hospital—and racking up more medical bills.
Board members from Mary Washington Healthcare and Pinnacle began organizing
the alliance about three years ago. It now includes Mary Washington Hospital’s
locations in Fredericksburg and Stafford County, related centers such
as those providing imaging and about 400 area physicians in 37 specialties.
“I think anybody who has to deal with the crisis of health care costs
realizes that something has to be done,” Janus said. “The
system as it stands right now is unsustainable. Employers can’t
afford double-digit raises in health care.”
The alliance started with MWHC’s employees and their families, and
was expanded to include area residents who are eligible for Medicare.
It isn’t an insurance plan, but there are plans to expand the alliance
to include more people in the area and enter into similar agreements with
“In the past, employers worked through commercial insurers and that’s
the pricing mechanism for the community,” Turner said. “Now
the employer, insurance company and delivery system can sit down and have
those conversations, which we’re doing with lots of self-insured