Redefining Independence
As clinicians, we’ve been managing unprecedented change and challenges in healthcare. Issues such as increasing consolidation, changes in regulatory rules and reporting, along with payor contracting demands have all contributed to an ever-evolving healthcare landscape. With this consolidation the landscape is shifting as more private practice doctors are absorbed into “supergroups” or private equity organizations. This shift is causing many doctors, cardiologists in particular, to choose between giving up their independence or spending an increasing amount of time on administrative tasks.
A recent McKinsey report found private-equity healthcare deal volume growing much faster than other industries. Private-equity and venture capital deal growth rose at a 29 percent annualized rate from 2014 to 2021, compared to only about a two percent growth in deals across all industries. Today, more than 70 percent of U.S. cardiologists are no longer independent physicians, but are employed by hospitals and health care systems. This is a dramatic shift from years ago when almost all cardiologists worked in private practice.
We have an opportunity to help independent cardiologists by supporting them with better practice management systems that accelerate clinical quality, financial performance and long-term growth, while also giving cardiologists more time to focus on patients.
Growing need, shifting models
With an aging population and increases in comorbidities including diabetes and hypertension, the need for Cardiovascular Disease (CVD) treatment will grow. Based on a U.S. census data study, by 2060 the number of people in the U.S. with ischemic heart disease is expected to reach 28.7M, heart failure 12.9M and myocardial infarction to 16M active cases – a growth of 30 percent or more in the number of cases. The occurrence of CVD in younger and younger patients in the U.S. is particularly concerning. Preliminary data from the CDC found that among 35- to 54-year-old adults, deaths from heart disease increased by 12 percent in 2020.
Many physicians join larger practices or private equity groups to offload administrative duties and focus on patients, but this comes with restrictions and requirements on how they care for patients that can limit a doctor’s options and even their identity as the person deciding the best care for each patient. The outcomes for patients with practice consolidation are not as strong as what physicians are promised. A recent AHIP article noted that a practice acquisition actually leads to an increase in cost of care by 14 percent, and practice acquisition did not improve the quality of care for the overwhelming majority of measured criteria, and also led to lower patient satisfaction. This leads to frustration and highlights the opportunity for independent physicians.
On the other hand, private practice gives physicians more freedom and flexibility, but also more administrative work. An AMA survey found that the smaller the practice, the more likely physicians were to handle administrative tasks on their own. “You’re everything,” said a doctor with a small family medicine practice in the South. “You’re the physician, you’re the manager, you’re the human resource person, you’re the computer technician. Everything falls on your head.” When you add in payroll, EMR management, MIPS reporting and other paperwork, cardiologists say to us that they can spend more than 17 hours a week on paperwork alone.
With this growing need, we need to find ways to use technology and centralized support to efficiently run small to medium sized practices. That’s why we started CardioOne.
Redefining independence
Over the past 25 years, I’ve served as a leader, operator and practicing physician with organizations such as TeamHealth, Navvis, CareCentrix, and as an educator and leader at UMass Chan School of Medicine and UMass Memorial Healthcare. I know the challenges of managing Medicare requirements on one hand, and I also respect the ability of cardiologists to make their own care decisions, or set their own schedules. These freedoms are often lost when joining a big practice. But I don’t want to tell someone how to be a cardiologist – I’d rather help them focus on the patient experience.
CardioOne is a next-generation network of independent cardiology practices, and I stress the independence aspect. We designed CardioOne to ease the burden of managing a practice while accelerating clinical quality, financial performance and growth. We want to empower cardiologists to remain independent and thrive in an increasingly demanding practice environment, while having more control and flexibility over hours.
While independence is important, there are also advantages to scale – working with EMRs, rolling out new technology to enhance revenue streams and efficiency, negotiating with payers, these all call for large-scale efficiency. That’s why I see CardioOne as a unique offering. We can provide independent cardiologists with the benefits of national scale by leveraging our network, technology, services, contracts and expertise. We can help cardiologists provide services like care coordination, practice optimization and staff management to support more flexibility.
As demand for cardiology services grows, we’re also seeing a shift with more value-based contracts in cardiology, which changes payment models and requires additional tools for success. These tools include enhanced patient engagement and monitoring with expanded integrations across the continuum coupled with new reporting and analytics. The American College of Cardiology has called for prioritizing patient-centered payment models, addressing health equity and promoting innovation and improvements in cardiovascular care. The 2023 CMS fee schedule cut reimbursements for cardiologists, reflecting the need for physicians to migrate into newer reimbursement models or face further reduction in their incomes. CardioOne’s leadership team is steeped in experience in managing value-based contracts. We are bringing the technical and operational tools to allow our partners to participate and thrive in today’s fee-for-service environment and tomorrow’s coming value-based world.
“By removing the heavy administrative burden of practice management, we are able to focus on what matters the most…spending quality time with our patients.”
Barbara Hutchinson MD PhD FACC
We’re already hearing about the benefits from the physician partners we’re working with. There’s a family cardiology practice where they’re excited for the opportunity to offer their patients the digital conveniences they expect, while helping their practice thrive. We’re hearing about success from other doctors, such as Dr. Barbara Hutchinson, owner of Chesapeake Cardiac Care in Maryland, who said, “As physicians, we strive to provide best-in-class care to our patients and community. By removing the heavy administrative burden of practice management, we are able to focus on what matters the most…spending quality time with our patients.”
Built for the future
Looking down the road, the need for cardiology treatment will continue to grow. Doctors want to see patients, not paperwork. But with Medicare rolling out more value-based contracts for cardiology, tracking outcomes and care scores will make this complicated. If we want independent doctors to stay independent, we need to provide cardiologists with the advantages of national scale with CardioOne’s network, technology, services and expertise. This will enable practices to deliver the most advanced care and achieve sustainable growth, while preserving clinical autonomy and reducing administrative overload.
