As health reform looms, a new leader at YMG

In March Paul Taheri, M.D., M.B.A., left Shelburne, Vt., a suburb of Burlington, for a new job in New Haven. Taheri, who had led the University of Vermont Medical Group since 2007, arrived to take over as CEO of Yale Medical Group (YMG). He moved from overseeing a 500-physician multispecialty group to leading one that has more than 1,000 physicians, mostly specialists.

“Yale is a bigger enterprise,” said Taheri, who will also serve as deputy dean at the School of Medicine. Yale’s location on an axis that includes such powerhouse medical centers as New York City and Boston places it, Taheri said, in the “hotbed of innovation and delivery.”

That said, Taheri’s move to New Haven comes at a time of imminent change in medicine both nationally and locally. President Obama’s health care reform takes effect next year, with anticipated cuts in reimbursement from Medicaid and Medicare as well as other changes in the financial model of medical practice. Many in medicine foresee a shortage of physicians at the same time that thousands of new patients are expected to enroll in Medicare. The shortage of primary care doctors is of particular concern, Taheri said. “The general trend in American health care is placing a greater emphasis on primary care,” he said. “We have to figure out how to either integrate or build relationships with primary care providers. I suspect that is where the practice will grow.”

The clinical practice at Yale has seen major expansion over the past decade—the size of the clinical faculty has grown; clinical revenues have nearly doubled; and clinical programs have expanded in breadth and depth—but leadership at the medical school and within YMG see a need for a more centralized and unified physician group practice.

Taheri agrees, and achieving that is among his immediate priorities. “Figuring out how we govern ourselves will be a very big issue,” he said. “Ultimately things need to come to some pinnacle and have decisions made by the group.”

He’s also hoping to continue the move toward standardized customer service throughout the medical group’s practices. “How does registration work? How are patients brought to the room? What person is doing what in the clinic?” he said. “Whether they go to New London or Bridgeport, it should be the same experience. There are huge benefits to standardization.”

Taheri was credited with preparing the medical practice at UVM for the future of health care reform both financially and operationally. He established the Fletcher Allen Center for Health Care Management to provide business training for physicians, nurses, and administrators; and he led the UVM Medical Group Revenue Department to achieve national ranking among its peers.

YMG, he said, is well positioned to weather coming storms, Taheri said. “You have world-class faculty,” he said. “You have a great brand. You still have leverage with the payers. As long as we are data-driven, thoughtful, methodical, we can manage the changes and balance all the missions of the enterprise, and come out more able to bear risk.”

Taheri succeeds David J. Leffell, M.D., director and later CEO of YMG, who led the transformation of YMG over the past 15 years while continuing to direct the Section of Dermatologic Surgery and Cutaneous Oncology. Leffell’s leadership has advanced YMG’s reputation for quality of care and service, and he spearheaded many initiatives, including the branding of the clinical practice under the name Yale Medical Group; establishing first-rate billing, collections, and compliance functions; and selecting Epic as the medical center’s first integrated electronic health record. Michael Berman, M.D., who directed the initial restructuring of the practice, oversaw its operations as interim director and CEO during the past year.