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David MoyeJanuary 31, 2019

Are Medical Super Groups the Answer to Succeeding in Value-Based Reimbursement?

Physician holding clipboard.

Moving toward a value-based methodology has proven to be burdensome for independent medical practices. With the shift, practices tend to face small group discrimination, escalating administrative loads and costly technology requirements.

 

This has led many practices to consider alternative practice models, including joining or forming a medical super group. Super groups, supported by a Management Service Organization (MSOs), are formed when two or more independent medical practices come together to form a professional partnership. They build on the Independent Practice Association (IPA) model to offer independent physicians collective bargaining with payers, as well as operational services and on-site support.

 

IPAs facilitate education and collaboration among independent practices, helping them understand new clinical practices and how to apply regulatory and quality-standards requirements. However, IPAs typically are not staffed to provide operational services for member practices while super groups are.

 

Super Groups and Their Role in Today’s Healthcare Climate

Operating as a professional partnership under a single tax ID, medical super groups share technology, data analytics, revenue cycle management and practice management resources to achieve economies of scale and scope. This results in practice having increased negotiation power, accreditation compliance, freedom to focus on patient care and a competitive advantage.

 

Super groups are also staffed to provide comprehensive administrative support services that compliment a practice’s existing employees. Services often include accounting and financial reporting, accounts payable, training and other added services.

 

Under value-based care, performance based revenue models require independent practices to provide a number of services that the past traditional fee-for-service model did not. New services result in increased duties for both providers and independent practices as a whole.


Instead of using existing staff, or hiring new staff, to measure and manage these metrics, super groups share these added responsibilities and expenses with all practices involved. Added technological resources also cut down on administrative and operational costs and duties, giving you the time to focus on what’s most important: your patients.

 

Sharing duties with other practices also gives super group practices the opportunity to benchmark provider performance with internal peers. This added advantage gives you a leg up when it comes to value-based care, providing your practice with even more resources to utilize.    

 

Ultimately, the higher your quality score and the lower your costs, the more money you earn. And, forming or joining a super group can allow your organization to do just that, resulting in increased value-based reimbursement and increased financial stability.

 

Once forming or joining a super group, another option to consider when trying to enhance your practice’s value-based care is partnering with a vendor who can offer revenue cycle and practice management services. With increased personnel, volume and resources, your newly formed super group will need to find opportunities to create efficiencies and operate at a larger scale. Many independent practices are working with third-party vendors who can provide support with many time-consuming administrative areas such as billing services, coding education, quality and compliance, etc. These outside partners are giving practice owners valuable time back to refocus their efforts on providing quality patient care.

 

To learn more about how independent practices are thriving with R1’s support, click on the case studies listed below: