Doctor enablement firm Privia Well being (Nasdaq: PRVA) noticed its 10 ACOs achieved mixture shared financial savings of $176.6 million in 2023 via the Medicare Shared Financial savings Program (MSSP), a 34.1% enhance from 2022. Nationwide, the Arlington, Va.-based firm works with greater than 4,500 suppliers on apply enchancment and value-based care. Keith Fernandez, M.D., the corporate’s chief scientific officer, just lately spoke with Healthcare Innovation about what’s behind Privia’s progress.
During the last seven years, Fernandez has led Arlington, Va.-based Privia’s Gulf Coast market’s participation within the MSSP. Previous to becoming a member of Privia, he served as president and physician-in-chief of the Memorial Hermann Doctor Community (MHMD), chief medical officer of the Memorial Hermann Accountable Care Group, and chairman of MHMD’s Scientific Applications Committee.
Healthcare Innovation: What are a few of your day-to-day duties as chief scientific officer at Privia?
Fernandez: I’ve duties within the Houston marketplace for value-based care within the Medicare Shared Financial savings Program. I additionally run the nationwide doctor advisory council, which appears at what we ought to be doing for physicians, for practices, for sufferers. We now have a number of packages making an attempt to assist change the course of diabetes within the nation: superior sickness administration, superior care planning, taking good care of the sickest sufferers. We now have additionally developed a nationwide scientific management program. We put our physicians and clinicians via a one-year course that’s two days each different month away out of your apply, a really intense management course. We have seen simply exceptional outcomes with that and an engagement degree that I do not assume I’ve ever seen earlier than. I additionally lead the scientific analysis program at Privia as properly.
HCI: There are a number of different high-profile doctor enablement firms on the market — Aledade and Lumeris, as an illustration. What are some issues which are distinctive to Privia’s enterprise mannequin that attracts practices to hitch it? And is it primarily main care practices or additionally specialty teams?
Fernandez: We’re dominated by main care, however we have now a considerable variety of specialists and multispecialty teams. The truth is, a main aim is to combine the medical specialists with the first care medical doctors. I believe one of many variations between us and different firms is, usually, it’s important to change your EMR. In case you take heed to medical doctors, altering the EMR is among the greatest hills to climb, and the opposite fashions do not make medical doctors do this. It’s a critical benefit for us to have the overwhelming majority of our physicians on a single EMR. Meaning our nationwide group has to be taught one EMR, our information analytics and medical economics persons are coping with one platform.
HCI: Which EHR do you employ?
Fernandez: We use athena. We’ll possible be utilizing different EMRs sooner or later, simply because to proceed to develop we will have to vary a bit bit ourselves. The athena platform is a superb platform for our functions — the value-based care side, and our groups having the ability to work in that platform together with the physicians. It makes the job considerably simpler.
HCI: Are there different infrastructure items that you simply standardize on for the clinicians, like different well being IT modules that you simply make one resolution on after which unfold it out throughout the group?
Fernandez: Completely. We now have a nationwide scientific IT advisory council, which engages alongside the traces of: Does all people want their very own selection of software program on this or can we standardize as acceptable? It is actually the physicians engaged in making a choice that’s each business-wise and workload-wise a profit to the medical doctors. It has been one of many principal issues that has allowed us to speed up that course of. It permits us to have physicians speaking to physicians, and permits the businesspeople to remain out of the dialog, so we get excellent adoption for the overwhelming majority of issues.
HCI: I form of interrupted you after I was asking what makes Privia’s enterprise mannequin distinctive, and also you talked about getting all people on the identical EHR. Had been there another belongings you wished to say?
Fernandez: Sure, completely. We’re partnering with a doctor round their complete apply. Why do a management program? It is as a result of we wish these physicians serving to not simply their apply, but in addition serving to different practices be taught the individuals, course of and know-how methods of constructing the apply simpler. We do the contracting for them. We now have the payer contracts. For some, it’s simply within the MSSP. Some others, it is simply in Medicare Benefit. We do the entire package deal, industrial and Medicare. The dimensions and the group that we have now, the experience that we have now, takes an enormous burden off of these practices.
HCI: It sounds such as you meet individuals the place they’re on their journey to value-based care.
Fernandez: We do as a result of some individuals might are available with some expertise already, however for others, it could be new, or they’re nonetheless principally in charge for service.
We discuss that when it comes to maturation. The Houston market had many medical doctors who had already been within the Medicare Shared Financial savings Program so it began out as a reasonably mature market. However within the Washington state market and the Abilene market, there was not a complete lot of that form of exercise. So we do meet them the place they’re. We now have coaching packages, as an illustration, in value-based care. Extra importantly, we have now a mentorship program We now have physicians, nurse practitioners, and workplace managers who assist so that individuals can get acclimated to the the surroundings extra shortly. It is nonetheless a journey.
HCI: Final fall Privia introduced a partnership with an organization referred to as Navina. Might you discuss a number of the ache factors that practices have gathering information that this work with Navina may assist deal with?
Fernandez: When a doctor is making an attempt to take care of a affected person, having the entire info out there about that affected person is absolutely essential. As essential is having the time for the doctor and the affected person to really meet and resolve what could be mistaken and what could be the perfect plan of action. What has occurred to healthcare through the years is that quite a lot of that point has been sucked away, so the assembly with the affected person turns into a bit extra transactional.
So certainly one of our main precepts is that we have to take a number of the burden off of the physician. There are exterior sources of data — HIEs, as an illustration, that aren’t seamlessly built-in into the EMR. There’s info that the payer has, and there are issues which are within the EMR, however unintelligible. The Navina software means that you can discover issues that chart prep work might not discover. We have completed a bit work with them and located a major variety of issues that we would already regarded for fairly extensively and hadn’t discovered.
Additionally, when Navina finds one thing, you may then click on on it and transfer it to to the suitable place. We predict this has improved our efficiency. It additionally helps with danger coding. One of many points round danger coding is you need it to be correct, proper? Nicely-documented danger coding, not gaming. We’re very, very critical about that stuff and our audit charges have improved dramatically with this software. We’re offering a way more correct image of that affected person with this software.
HCI: Are you exploring different AI instruments, like scribes for be aware taking?
Fernandez: I believe it is essential that our medical doctors experiment. We’re studying from that to discover a path ahead with those that could be probably the most profitable.
HCI: I noticed a weblog written by Fred Taweel, M.D., who’s the chief medical officer for the Privia group within the Mid-Atlantic. He highlighted that you’ve recurring conferences, the place practices’ metrics are transparently and objectively portrayed. He stated you may assume that may result in finger pointing or blaming, however he stated it does not have that impact. It fosters constructive conversations. Are you able to discuss a bit bit about why that is the case and your expertise of these conferences?
Fernandez: Sure, and I’d agree with Fred. We now have constructed a tradition within the group that we’re right here to assist individuals, not simply the medical doctors however the medical assistants and the workplace managers, too.
At certainly one of our current retreats we assigned seating and put the information on the tables so that everyone on the desk might see it. We purposefully put collectively the individuals who had been getting A’s on their report playing cards with individuals getting C’s on their report playing cards. At first, they thought this was the silliest factor on earth. However by the tip of the assembly, they stated that is the perfect factor we have ever completed, and it was as a result of they had been studying from one another.
HCI: It appears like Privia continues to develop. Did I simply see an announcement that it’s getting into the Indiana market? Do you’re employed by discovering an anchor apply in a brand new state and work with them, after which increase from there?
Fernandez: Sure, we discover an anchor accomplice. It often takes us some time to search out one which each is the kind of apply we wish to get and that desires to hitch us. We do not purchase practices, which is one other differentiator with many organizations, specifically, hospitals. So the engagement we get will not be as a result of we gave them an enormous test; it is as a result of they’ve a imaginative and prescient. A lot of them wish to be in a physician-led group. They usually wish to take actually nice care of sufferers and enhance outcomes.
