Rajiv Chopra is a principal and CFO for The C/N Group, a healthcare services company.
Q: You have seen an increase in the 'one-stop-shop' model for providing care — organizations looking to provide services for the entire patient experience, from assessment to treatment to rehabilitation, under one roof. What do see as the driving force behind this model?
Rajiv Chopra: The economics are driving it to the extent that physician fees for just purely seeing the patient or for performing a surgery are declining, in some cases very dramatically. Then you've got to access ancillary revenue sources. If you're a physician practice where before you might have been referring x-rays, CTs, MRIs, ultrasounds, etc., to someone else, if you can capture those ancillary revenues and do so profitably, you have to keep those in-house. You do need to have a critical mass of physicians to do things like that, it's driving consolidation.
Q: What else is encouraging growth of this model?
RC: The clinical benefits and patient convenience, proven or otherwise. If you can have integrated care, instead of sending a patient all over town for every link in the chain — diagnosis, treatment, rehab, PT and beyond — it can make a big difference.
This trend really blew up in part during the last decade due to plentiful access to credit. That has tailed off a bit, but I think that to the extent that you see consolidation of practices within particular specialties, then you'll probably see some more of these types of centers of excellence, these one-stop-shops. Three common examples popping up are cardio, orthopedics and women's health.
The potential changes via healthcare insurance reform (e.g. bundling of payments) are also driving this integrated care model.
Q: What makes this model appealing to referring physicians?
RC: When you say center of excellence, everyone understands what that's supposed to mean. Let's say you're an internal medicine or primary care physician and you want to refer one of your patient's for breast care, for example. Breast care centers have mammography, some interventional radiology, some surgery component — from a marketing standpoint, it sells.
Q: What kinds of markets are most primed for this model?
RC: In markets where you can scale — you really have to have a large number of doctors for this model to be profitable. In markets where there's a university tie-in or a tie-in to a hospital, I think you'll see more of these centers of excellence.
Q: What is a major challenge you see with this model?
RC: It should be big but it needs to be personalized delivery and that's what the challenge is — how do you get big and still deliver personalized care a patient expects? This must be addressed and not forgotten.
Learn more about The C/N Group at www.thecng.com.
Q: You have seen an increase in the 'one-stop-shop' model for providing care — organizations looking to provide services for the entire patient experience, from assessment to treatment to rehabilitation, under one roof. What do see as the driving force behind this model?
Rajiv Chopra: The economics are driving it to the extent that physician fees for just purely seeing the patient or for performing a surgery are declining, in some cases very dramatically. Then you've got to access ancillary revenue sources. If you're a physician practice where before you might have been referring x-rays, CTs, MRIs, ultrasounds, etc., to someone else, if you can capture those ancillary revenues and do so profitably, you have to keep those in-house. You do need to have a critical mass of physicians to do things like that, it's driving consolidation.
Q: What else is encouraging growth of this model?
RC: The clinical benefits and patient convenience, proven or otherwise. If you can have integrated care, instead of sending a patient all over town for every link in the chain — diagnosis, treatment, rehab, PT and beyond — it can make a big difference.
This trend really blew up in part during the last decade due to plentiful access to credit. That has tailed off a bit, but I think that to the extent that you see consolidation of practices within particular specialties, then you'll probably see some more of these types of centers of excellence, these one-stop-shops. Three common examples popping up are cardio, orthopedics and women's health.
The potential changes via healthcare insurance reform (e.g. bundling of payments) are also driving this integrated care model.
Q: What makes this model appealing to referring physicians?
RC: When you say center of excellence, everyone understands what that's supposed to mean. Let's say you're an internal medicine or primary care physician and you want to refer one of your patient's for breast care, for example. Breast care centers have mammography, some interventional radiology, some surgery component — from a marketing standpoint, it sells.
Q: What kinds of markets are most primed for this model?
RC: In markets where you can scale — you really have to have a large number of doctors for this model to be profitable. In markets where there's a university tie-in or a tie-in to a hospital, I think you'll see more of these centers of excellence.
Q: What is a major challenge you see with this model?
RC: It should be big but it needs to be personalized delivery and that's what the challenge is — how do you get big and still deliver personalized care a patient expects? This must be addressed and not forgotten.
Learn more about The C/N Group at www.thecng.com.