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Small Practices Forging Ahead in Value-Based Care : Page 5 of 5

Small Practices Forging Ahead in Value-Based Care : Page 5 of 5

TruHealth Family Care

In Fayetteville, Ark., Mark Miller, a family medicine physician, heads up his own small practice and cares for mostly Medicare (40 percent) and commercially insured patients, with a few self-pay patients mixed in. He employs two advanced practitioners, one of whom is full time and the other part time. "We don't have a booming practice, we like to take our time to see people and don't like to rush people through," he says. "I'm not a volume-based guy. I don't like seeing 50 people per day."

It's no surprise then that his team would be involved with value-based care, initially through participation in an ACO and currently through a clinically integrated network (CIN). Like Pearlman, the ACO didn't provide any kind of financial benefit for his practice and so he dropped out last year. With the CIN, Miller is working with fellow independent physicians like himself, employed physicians, and leaders at Northwest Health Systems in Arkansas to create quality-care incentives.

"Once we have a set number of providers, this fall, we're going to go to the payers — and we already have some lined up — to start contractual talks," says Miller. To get fellow physicians to participate in the CIN, Miller says he is selling physicians on the concept of more face time with patients. He also says there is no front-end risk for physicians. "There is no entry fee. There will be a fee later, but it will be taken out of any money you receive from shared savings," he says. Another benefit he says is that physicians in the CIN get access to claims data.

Many physicians, Miller says, are worried about this last part, sharing information with people who may be their competitors. He says that's a valid concern. Overall though, Miller is bullish on value-based care and says, "This is the only way to contain costs." His advice to fellow small-practice physicians is to get involved and provide input. "When you're involved, there is a lot of education about the process that you get by default. That has been beneficial for me to learn how it works."

Gabriel Perna is managing editor for Physicians Practice. He can be reached at gabriel.perna@ubm.com.

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