Membership-based primary care programs: Holy Cross Health CEO shares lessons learned and best practices

When it comes to primary care, consumers are seeking maximum convenience. Hospitals and health systems are finding that membership-based primary care models can create a more convenient experience for patients and offer more flexibility to overburdened clinicians.

Becker's Hospital Review recently spoke with Mark Doyle, president and CEO of Holy Cross Health in Fort Lauderdale, Fla., about his institution's experience with MDVIP's membership-based medicine program.

Note: Responses have been edited for length and clarity.

Question: How has membership-based medicine enabled your health system to address changing consumer demand?

Mark Doyle: As an integrated health system, physician availability and convenience are challenges we always have. As healthcare becomes more commoditized, organizations that can provide consumers with the services they really want, like better availability and convenience, will be the clear winners. Our patient demographic is older. About 65 percent of our patients are above the age of 55 - they have more medical needs and more acute needs. Offering a member-based program that gives patients immediate availability to Holy Cross doctors and more time with a physician seems like clear winners in terms of serving those individuals.

Initially, we looked at developing a membership-based primary care program in-house, but as we talked with MDVIP and saw their model and their analytics, the decision was clear. MDVIP has the expertise to get us to the next level.

Q: How does the membership-based primary care program partnership with MDVIP fit into future strategies for Holy Cross Health?

MD: We are growing our primary care network in the new age of value-based healthcare which focuses on keeping patients out of the hospital. One way to do this is through smaller patient panels. Some of our primary care physicians have 2,500 patients in their panels. In contrast, the new MDVIP membership-based primary care model has about 450 patients per panel.

Membership-based care is more personal. Smaller panels mean that physicians can manage and keep their patients' overall health in check spiritually, mentally and physically.

Q: What has been the response to the membership-based primary care partnership between MDVIP and Holy Cross? Has it met your expectations?

MD: Absolutely. When we started the process with MDVIP, they identified six doctors who met their criteria and two decided to participate. The program has been so successful that we are already looking to add several more doctors to the MDVIP program, and we are anticipating the same type of success in the market.

Q: Can you talk about whether this program helps address the problem of primary care physician burnout?

MD: With 15-minute-increment schedules, some primary care doctors see 25 to 30 patients a day. I'm sure that is exhausting. When the membership-based primary care model came along, some physicians were hesitant. Some like having large patient panels and seeing a wide variety of patients every day. Others, however, really gravitated to the program because it offers a better lifestyle. Instead of seeing 30 patients in one day, they see fewer than 10.

Physicians say the program has been a godsend. Some were burned out and ready to retire. During the initial phase of this program, the participating physicians tended to be more senior. Now younger physicians are showing interest, after seeing the physician success and satisfaction with the model. We had a husband and wife in their 30s say that they want to become MDVIP doctors because they have young children. The membership-based primary care program offers a lifestyle and compensation commensurate with what they want, but without as many patients and strenuous hours. I think you'll see more physicians choosing this option.

MDVIP has also been a great recruitment tool for us. We want to offer different options for primary care physicians. Some want to stay in traditional models, some are moving to the Medicare Advantage capitated plans, and others want the MDVIP model. By offering three different primary care models, doctors can move back and forth, depending on their needs and lifestyle preferences.

Q: I understand that MDVIP performs an analysis of your physician network. Were you surprised by the results? If yes, could you tell us why?

MD: MDVIP has incredible analytics. Based on demographic information, they pinpointed the practice locations that are most likely to be winners and which ones aren't good candidates. They also identified all our doctors, how many patients they were seeing per day, the average age of the patients, and even in some cases the patients' propensity to join. We found that some physicians had panels of around 200 patients, but they should have had 3,000. It was definitely eye opening to have that level of analysis, since we thought we were operating more efficiently and robustly than we actually were.

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