New York Supplier Group and insurance company partners develop a new integrated delivery system


Community Care Physicians and Capital District Physicians’ Health Plan have joined forces to create a new managed services organization to maintain its independence while outsourcing the administrative operations of an independent multi-professional provider group.

The doctor-owned medical group employs 420 clinicians in 70 counties in and around Albany, New York, where both companies are headquartered. This non-profit insurance company provides insurance to 400,000 people in 29 northern counties in the group, individual, and public sector markets. The two companies announced last week that the partnership is expected to be completed before the end of the year, subject to state regulatory approval.

When the management service organization is in place, the community nursing physicians did not respond to interview requests and will remain independent. The medical group will retain its contracts with other payers and outsource its revenue cycle, human resources and technical operations to the doctors’ health plan in the capital region.

More and more providers are seeking to integrate their operations more closely with payers in an effort to accept a greater portion of patient risks.Nearly 60% of health systems plan to enter the risk-based Medicare Advantage payment model next year, and at least 30% will follow the community care doctor’s model and work with payers to establish data integrity, reporting, and technical capabilities. Survey results The Healthcare Financial Management Association released this month.

Dr. John Bennett, CEO of Capital District Physicians’ Health Plan, said that regional non-profit insurance companies are participating in many of these companies. The partners will jointly carry out risk-sharing arrangements and integrate their functions into an integrated system.

“We want to make our patients healthier, and we know it will save costs,” Bennett said. “But our goal is to make doctors become doctors, let them practice and be with patients.”

There are fewer doctors than ever According to a recent survey by Avalere Health, it has its own practice. Many of the remaining independent doctors are looking for alternatives to company ownership, such as joining regional non-profit health plans or signing contracts with doctor-supported startups such as Agilon Health, allowing them to outsource the management functions of their businesses, said Rick Kes, the consulting firm RSM’s Healthcare partner.

“Usually, if you ask a doctor, they will say,’I think the best option is to keep us independent and provide the care that these patients have experienced before without any interference.'” Kes said. “Now that there are tools, technologies, and companies that can do this, the practices of these doctors have aroused more significant interest.”



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