HIMSSCast: Physician groups unite on accountable care

Susan Dentzer, president and chief executive officer of America’s Physician Groups, keeps pushing the needle on value-based care.

APG represents over 360 medium-to-large physician groups that provide care to 90 million patients – about one in four Americans. The organization includes independent physician groups, as well as those affiliated with hospitals.

What unites them is that all of the physician groups represented by APG are held accountable for the cost and quality of care.

They also take care of about a third of Medicare Advantage enrollees in the country, Dentzer said. Medicare Advantage, being based on capitated payment rates, is one of the biggest value-based programs in the country.

“Far and away,” she said, “more of our groups are in Medicare Advantage and have accountability for the total cost of care.”

For more on Dentzer’s take on the future of value-based care, listen to her interview with Susan Morse, executive editor of Healthcare Finance News.

Talking Points:

• The best performing accountable care organizations are led by physicians.
• Fewer than half of physicians in this country are involved in a value-based care model.
• The presence of employers who offer coverage to their employees in value-based care models is minimal.
• Employers’ collective weight is needed to push the system to more value.
• Physicians who are not in value-based models see 20 patients a day to float the financial boat. APG groups providing team-based care are not limited to 12-minute visits with patients.
• Value-based care is able to include resources for the social determinants of health, such as food, transportation and social needs for patients.
• Dentzer recently joined the Health Care Payment Learning & Action Network’s Accountable Care Action Collaborative, an organization working to accelerate the adoption of alternative payment models.

More About this Episode:

ACO Reach now includes financial protections from midyear benchmark changes 

Medicare Shared Savings saved Medicare $1.8 billion in 2022

CMS is testing new primary care model

CMS releases three initiatives to grow Medicare ACO participation

Susan Dentzer named president and CEO of America’s Physician Groups

Twitter: @SusanJMorse
Email the writer: SMorse@himss.org