In our last blog, we introduced AppleCare Medical Group, an independent practice association in California that has successfully managed risk since its inception in 1996. The IPA has done so by following a number of guiding principles, including carefully analyzing its new contracts to make sure the opportunities and risks each one presents is clear.
Another key principle in managing risk, from AppleCare’s perspective, is making sure to obtain and maintain physician cooperation and buy-in. Physicians make the biggest difference in provider-based risk management, and as AppleCare co-founder Vinod Jivrajka, MD, has said, when doctors are happy, patients are happy. To this end, AppleCare works hard to make sure its physicians are well supported in all aspects of patient management so they can focus on taking care of their patients and practice.
AppleCare co-founder Surendra Jain, MD, said treating doctors like partners, especially when it comes to sharing incentives, is crucial. Physicians understand risk, and they know it gives them the opportunity to benefit from their efforts.
But keeping doctors happy takes more than answering their phone calls and resolving their concerns. Jain emphasized that corporate culture needs to be carefully directed towards care coordination. It starts with the leaders, he said, and then follows with the primary care providers, specialists, ancillary providers and hospitals.
The corporate culture of AppleCare has evolved over the past decade to become rigorously provider-centric. Everything from claims processing, to capitation management to bonus programs is executed with the physician as the customer. The same goes for clinical programs, such as those which manage the cost of medications, reduce unnecessary surgeries, increase access to palliative care, or enroll more patients in case management.
In our next blog: How data and analytics are supporting AppleCare’s risk-based business.
To learn more about how AppleCare successfully manages risk, download the case study.