Summit Health: A Pioneering New Jersey Medical Group Expands its Reach Out West

A pioneering multispecialty medical group based in northern New Jersey is expanding its reach—literally—across the country. The 500-physician, Berkeley Heights, New Jersey-based Summit Medical Group on Sep. 14 announced that its recently created Summit Health Management (SHM) management company has “unveiled transactions today that will extend its highly effective patient care and physician group management model outside of New Jersey,” according to a press release made public this morning. “In Oregon, a Letter of Intent to provide administrative, clinical and financial management services has been signed with Bend Memorial Clinic (BMC), the largest independent multi-specialty physician group in its region, with 120 providers,” the press release stated. Meanwhile, “In the Greater Phoenix area, SHM will join 51 providers currently affiliated as Arizona Primary Care Physicians (APC) to form Summit Medical Group Arizona as of January 1, 2018. Additionally, APC has entered into a comprehensive management services contract with SHM to facilitate the partnership and transition,” the press release noted.

“The rapidly evolving health care landscape is requiring independent physician groups across the country to make pivotal decisions that will shape their future and the delivery of patient care. We are delighted that Bend Memorial Clinic and Arizona Primary Care have chosen to partner with us to retain their physician-owned and governed structures and patient-centric philosophy,” said Jeffrey LeBenger, chairman and CEO of both Summit Health Management and Summit Medical Group, in a statement in the press release. “We’ll help both of these partners to thrive and expand by sharing our resources and expertise in population health management and other emerging value-based care models. We are committed to a culture of collaboration across geographic boundaries with shared learning and uniform adoption of best practices.” SHM will provide Bend Memorial Clinic with comprehensive administrative, clinical and financial management services. 

Meanwhile, in Arizona, the press release stated, “Summit Medical Group Arizona will align like-minded medical providers in a physician-led group with a culture of caring and a patient-first philosophy. Utilizing SHM’s care and practice management model, it will deliver greater value and increased quality for the residents of Arizona.” Summit Medical Group Arizona is bringing together several separate practices affiliated under the identity of Arizona Primary Care, and which care for patients across the broader Phoenix metroplex.

Jeffrey LeBenger, M.D.

For Dr. LeBenger and his colleagues, Thursday’s announcement marks a natural progression for an organization that has been pioneering advanced medical management strategies and processes back home in New Jersey. Back in July, Dr. LeBenger told Healthcare Informatics that “We’ve done very, very well in our population health process, meaning that we beat the market in PMPM [per member per month] costs in the state of New Jersey by almost 8 percent in the past year. What we found out” in terms of how to achieve success under risk-based contracts, he said this summer, “is that you must share data with your physicians, meaning that you have to scrub it, you have to fix it, and you have to work with financial and clinical data together. And it has to be timely data—you need timely data from the payers. And you have to put the right data into the right health information exchange. And you have to understand where your high-cost points are in your model of healthcare.”

Meanwhile, the level of physician aggregation and operational management on the part of an established medical group, outside of established physician-led health systems like the Mayo Clinic and Cleveland Clinic, that was announced Thursday morning, remains unusual in U.S. healthcare. Given that, Dr. LeBenger made himself available to Healthcare Informatics Editor-in-Chief Mark Hagland for an exclusive interview, in order to elaborate on the strategies articulated in Thursday morning’s announcement. Below are excerpts from their interview about the announcement.

What would be the correct way to refer to the relationships between your organization and the physician groups in Bend and Phoenix?

In Phoenix, we are a minority owner in the Summit Medical Group of Arizona. Summit Health Management is a minority owner in Summit Medical Group of Arizona, and we have a long-term management services agreement for all management services. Summit Medical Group in New Jersey… Summit Medical Group of Arizona’s physicians will also be shareholders in the management company. And when you have physicians with the same mission, vision, and values—and focused on the value proposition of honesty, trust and transparency—you’re able to move the healthcare dollar to put the patients first—this is always about the patients.  This is about how we take care of patients; that’s what physicians are born and bred to do. So by creating a management company with similar drives and values as the group, and the same ownership structure, you can enhance a very well-integrated model.

And what is the correct terminology to describe the relationship with Bend Medical Clinic?

Bend Medical Clinic will continue as it is. Summit Health Management will assume all debt, hard assets, and workforce, and have a long-term management services agreement with the Bend Medical Clinic.

How do you see expanding your vision into these other markets that are quite different from the northern New Jersey healthcare market?

We have very good corporate talent here as Summit Health Management. And there’s good management talent in Bend and in Phoenix, on the medical management side. And we’re looking at best practices, in order to reach the Quadruple Aim—high quality, low cost, great patient experience, and high provider engagement. And we bring management skill and capital, and we bring maturity in governance and leadership, to be able to commit to a way of integrated healthcare practice.

One metric I love to talk about is that we’ve grown from 125 to 800 providers in the past six years, with less than 1 percent turnover. So having that dual ownership and management of the groups—we all have the same vision going forward.

How did you end up in these particular markets?

Our relationship with the physician group in Bend came from an investment bank, where we looked at their book of business. With regard to the group in Phoenix, we had met their senior leaders at conferences and meetings, and we ended up initiating a dialogue, and found what their constraints were as a loosely organized IPA [independent practice association] that has an overarching management company that offered contracts. And we started to speak with them, because they needed some capital, and the cultures of these groups were similar to ours. And that started a dialogue about moving in this direction.

Both groups are operating in markets in which there are progressive health plans whose senior executives have expressed the desire to collaborate further with providers. Do you see a fair amount of potential there?

Absolutely. In New Jersey, we have one of the most advanced commercial risk products, and we understand Medicare Advantage, and we understand NextGen [the NextGeneration accountable care organization program under the Medicare program]. And we feel there’s great opportunity to bring great quality at lower cost, with great patient satisfaction, and physician engagement.

And so you see great potential for partnerships with progressive health plans, in both markets?

Yes, I do.

How are you going to address physician social insecurity in the face of policy and payment changes? In other words, how are you addressing physician culture issues and challenges?

That’s number one for us. We would not have spoken to the physicians in either Phoenix or Bend, had they had not had a culture similar to ours. That was of utmost priority to us. If they didn’t have a similar culture of putting patients first, in the group practice context, we wouldn’t want to talk to them.

So you and your colleagues did your cultural due diligence, then, correct?

Yes, absolutely, that was first and foremost. I joke about this, but it’s like getting married! You really have to do your due diligence, and see what their culture is, whether it’s similar to yours or not. If not, it’s not worth it, because they wouldn’t have the same type of belief system, and that would make it impossible to move forward in the way we would want.

It seems as though this is a time of opportunity for physician group leaders with vision and who know what they’re doing, as policy and payment trends shift?

I have to say this, and it’s not rocket science, and I don’t want to sound arrogant. But if you develop a business model—we grow our primary care attribution, work closely with specialists—if you manage all transitions of care, and use the hospital as a center for tertiary and quaternary care, but keep 95 percent of care on the ambulatory side—that’s a recipe for success.

What should CIOs and CMIOs at hospital-based health systems be thinking about these developments?

Health systems always look at us as something of a threat; they think we’re trying to cull their network. That’s not the case. We view hospitals in a neutral way, even as we’re focused on the ambulatory side. We feel we can grow a network and take care of the patients on the ambulatory side, while finding ways to partner with hospitals on the inpatient side. We don’t look at hospitals as threats, and we never have. We look at hospitals as partners in performing good patient care, as we move patients as much as possible onto the ambulatory side. There is a good way to do this and to improve quality, collaboratively.

Meanwhile, at some point in the future, you’ll be expanding your operations further?

Yes. We are out in the market now, looking at opportunities in various markets.