Affiliations with community practices are a ‘win-win’ for everyone

YMG is currently pursuing discussions with more than two dozen practices

If you are a patient in a community medical practice, don’t be surprised if one day the sign outside the door changes. One trend is clear in the changing health care environment: community practices that were once completely independent organizations are affiliating with academic medical centers at an increasingly rapid pace. Yale Medical Group (YMG) is in various stages of affiliation discussions with more than two dozen community practices across Connecticut.

“This is the trend nationwide, and it’s certainly the trend at Yale Medical Group,” said Paul Taheri, MD, MBA, chief executive officer of YMG. “Affiliations are where we’re heading in the evolution of the health care environment, and it’s a win-win situation for everyone—us, the community practices joining YMG, patients, medical students, researchers, and anyone connected to the health care system.”

Drs. Daniel Price (seated) and Glen Henry lead Yale Cardiology Associates, the latest community practice to join Yale Medical Group.

Benefits for both sides

“It’s great for all sides,” said Glen A. Henry, MD, an interventional cardiologist. He and Daniel Price, MD, manage Yale Cardiology Associates, formerly Cardiology Associates of New Haven, PC. The 16-physician practice was established in 1977 and joined YMG last May, bringing its support staff and more than 36,000 patients who receive care in several locations. “The way medicine is going, particularly with the requirements for fully implemented electronic medical records systems—along with the research, education, and financial support we could get by being part of YMG—offered us a much-needed element of safety and security in our efforts to provide the best patient care possible,” Dr. Henry said.

Another practice that joined Yale Medical Group last year is the Urology Center, a six-physician group with offices at Yale-New Haven Hospital's Saint Raphael Campus and three other locations.

YMG’s benefits in these affiliations are immediate. They include the influx of a new team of highly-skilled clinicians who can both teach and provide care, along with increases in the number of patients who also might benefit from other specialty and subspecialty services in addition to opportunities for participation in clinical studies.

Day-to-day operations stay the same

Affiliation discussions are a multi-phased process and typically require months of due diligence. The YMG Board has a Network Development Committee that provides strategic oversight of discussions under way. Chaired by Peter Schulam, MD, the committee gets involved in the process as soon as a department chair identifies a new practice of interest. Committee members review the strategic value of the proposed affiliation, the financial analysis, and all aspects of a comprehensive due-diligence process. That includes IT and Epic readiness assessments; a medical records review for each physician; and a valuation of all fixed assets and facility reviews.

Once a practice joins YMG, its financial infrastructure and patient registration are managed by YMG staff. “The community practice doctors do give up some of their autonomy, but we try to leave the bulk of the organization intact,” said Dr. Taheri. “After all, they’re good at what they do, so we don’t want to be too meddlesome.”

“It’s a real win for the community practices. They really do get to outsource all of the administrative functions of the practice so they can focus solely on caring for patients,” said Karin Render, YMG director of strategic planning.

Dr. Taheri said patients shouldn’t notice much disruption. “If you’re a patient, except for the fact that your bill will come from YMG, you probably won’t notice much of a difference. You’ll still have the same nurses, doctors, and front office staff.”

“In general, this is a change for the good, since it enables us to better integrate the care of our patients and improve reliability, safety, and quality,” he added.