What the future holds
State of independence: How practices survive in a challenging healthcare climate

By: Leslie Small

Efforts aimed at increasing efficiency may help independent practices save money and draw more patients, but experts and providers interviewed by FiercePracticeManagement seem to agree that the most important goal is to ensure the survival of what many consider to be the gold standard in patient care.

For his part, orthopedist Louis Levitt, M.D., said joining the Centers for Advanced Orthopaedics, an organization that includes about 26 independent orthopedic practices in the Virgina-D.C.-Maryland region, has allowed his practice to maintain the strong provider-patient relationships that have defined more old-fashioned care models.

"We can preserve that mom-and-pop-shop type interactions that patients had with their private doctors," he said during an exclusive interview, adding that "we have autonomy that the hospital-based physicians just don't have."

Programs like Texas' PracticeEdge, a partnership between the 48,000-physician-strong Texas Medical Association and Blue Cross Blue Shield of Texas, also may hold promise for independent practices that want to remain in the game amid an area of seemingly unrelenting consolidation.

"I think this will kind of be a laboratory as to whether a concept like this will work or not," said Texas Medical Association President Austin King, M.D. "I'm sure that if it does work, it will rapidly spread to other state associations to try to put something like this together. But we'll have to give it a year or so and see what happens."

While there has indeed been an increase in private doctors seeking employment at larger health systems, David Gans, vice president of innovation and research for the Medical Group Management Association (MGMA), said the emergence of creative options for independent practices to remain viable means the model isn't likely to die out.

"I personally believe that there will be a continued shift in practice organization, but I don't think it will continue at the same pace," he said. In fact, MGMA's most recent data reveals that as of 2014, 68 percent of its member organizations were physician-owned.

Through a practice manager's eyes, Brandon Betancourt, who runs a Chicago-area pediatric practice, shares a similar view. "We haven't seen an exodus, if you will, of private practice," he said, adding that he believes independent practices are still "holding strong."

For Gans, though, one thing is certain: "We will continue to see significant evolution into how independent physicians practice," he said.

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