Physician organizations champion members’ successes

Health care changes rapidly for physicians and patients in the United States. It can cause upheaval and uncertainty. Being part of an organization that is dedicated to promoting the interests and well-being of a profession can be very beneficial to navigating these changing times.

Physicians represent the core of any organized delivery system. A physician organization (PO) is formed when a group of physicians or smaller physician groups come together to work positively to influence care delivery, improve patient care and earn incentives from cost savings. A PO represents physicians working toward ‘a common goal of improving the medical profession with which they are associated,’ according to the American College of Physicians.

Physician organizations support their members

A PO can be a powerful ally for its members in patient care, practice revenue, payer negotiations and more.

“Coming together under a physician organization creates strength in numbers,” said Dr. Karen Swanson, TPA’s chief medical officer and a primary care physician. This allows for greater negotiating power, collegial support and representation among payers, vendors, and others. Swanson adds, “This competitive advantage helps physicians be successful in practice performance and patient outcomes.”

A PO also champions its members by providing resources, information and opportunities that assist them in being a successful practitioner in an ever-changing healthcare industry. Member benefits can include additional infrastructure and support to help with physicians in pay for performance programs, patient care, education, coding and billing, advocacy, payer contracts, business service discounts, marketing resources, and other services.

The power of local representation

The Physician Alliance (TPA) formed in 2011 when five local physician organizations came together to provide a unified voice for physicians in southeast Michigan. TPA has grown to become the largest independent PO in the state, representing more than 2,300 members providing primary care and specialty care.

TPA members manage over 669,000 lives through multiple payers, including Blue Cross Blue Shield of Michigan, Health Alliance Plan, Blue Care Network and Priority Health. Through participation in BCBSM’s Physician Group Incentive Program (PGIP), TPA members have earned more than $142 million in value-based reimbursement payments since 2016.

Being an independent organization means that while TPA partners closely with Ascension Michigan and other health systems, the PO is a separate legal entity with its own board of managers and legal, financial and governing guidelines. Physician members are both private practice and employed by Ascension Michigan.

TPA provides practice support through staff and technology assistance, education, patient marketing materials and more. The practice resource team (PRT) also plays an integral role in supporting practices. A PRT member is assigned to a number of practices to help with closing gaps in care, achieve patient-centered medical home designation, earn value-based reimbursement, ensure practices understand pay for performance program requirements, and more.

Membership in TPA is open to board-certified and board eligible physicians with staff privileges at an accredited acute care hospital in southeast Michigan. Visit www.TPAdocs.com for more information on TPA member benefits.

The Physician Alliance member benefits:

• Participation in incentive-based programs

• Participation in managed care plans through St. John Partners In Care

• Nomination for BCBSM’s Patient Centered Medical Home designation for a 20% – 80% additional value-based reimbursement (VBR)

• Eligibility to receive up to 82% VBR for primary care and 5-10% VBR for specialty physicians through participating in BCBSM's Physician Group Incentive Program (PGIP)

• Free education webinars focused on important healthcare topics such as implementing legislative mandates, billing/collections, and technology updates

• Exclusive access to the Affiliate Partners Program, which provides preferred pricing to TPA members on a variety of business products and services

• Ability to participate in disease registry hosted by TPA to provide central repository of data for information sharing

• Opportunities to help TPA pilot new programs

• Networking opportunities with colleagues

• Access to digital newsletters full of news, updates and reminders related to the healthcare industry

• Updates on issues pertaining to Michigan health care via special reports, newsletters and meetings