How Independent Practices Are Staying Viable in Today's Changing Health Care Industry

Unified Women’s Healthcare of Washington Partners with National OB/GYN Group to Address Business Needs

Change is a given in every industry, but most of all in health care. Market forces are driving change and significantly impacting how physicians are doing business. Learning to adapt with new ways of doing things is essential to navigating today’s choppy waters.

Unified Women’s Healthcare of Washington, a group of three affiliated OB/GYN physician practices located in Bellingham (Bellingham OB/GYN), Bellevue (Bellegrove OB/GYN), and Kirkland (Center for Women), is an example of physicians doing things in a new way by joining forces with other regional practices and partnering with a national group to address business-management needs, such as cost reduction and resource- and service-sharing, to enable them to thrive and stay independent.

Equally important to maintaining their viability as a business, this affiliation and partnership is designed to let physicians focus on what they know best: taking care of patients.

Starting in 2015, UWH of WA began a partnership with a larger national organization called Unified Women Health (UWH). UWH contracts with Unified Physicians Management (UPM), which consists of some 1,100 OB/ GYN physicians and mid-level providers, and is the largest and fastest-growing group of OB/GYNs in the nation.

In addition to its groups in Washington, UWH has state physician groups in Texas, North Carolina, Georgia, and Florida. It is the only private-practice women’s health group with a singular vision that is 100 percent physician-governed.

Through UPM, Washington State's UWH has access to what is often described as a “back-office platform.” Some of the infrastructure and practice-management tools offered in that platform include:

  • Computers. UWH uses an Electronic Medical Record system with deep-data analytics and enhanced reporting capabilities, as well as cyber security protection.
  • Contracts. Working with a group of 30 with solid performance data and a professional negotiator has substantial benefits. Participating providers have a stronger position in contract negotiations with health plans because they represent significantly larger patient populations and, through their EHR, can demonstrate efficiencies and cost savings for health plans, as well as for patients and the practice.
  • Cost containment. This includes human resources, accounting, legal assistance, health insurance, a 401(k) plan, and medical-professional liability insurance. Group purchasing offers significant cost savings when practices buy in larger volume, and offers vendors the extensive ability to track inventory and supply use, which can enable them to get more favorable pricing.
  • Compliance. Federal, state, and local regulations for business and medical practices are complex. Having access to professionals focused on this task keeps the process smoother and much less burdensome for providers.

“The back-office platform is worthwhile for many reasons, but there are three key benefits,” says Michael Mallory, MD, president of UWH of WA, who has been in practice at Bellingham OB/GYN for 17 years. “The best-in-class Athena EMR platform that is specifically designed for private practice is the top reason.” He adds that this caliber of EMR is something most individual practices can’t afford.

The other two key reasons are increased leverage in contracting with payers and access to HR professional expertise and benefits.

While there are many benefits to the back-office platform, there are drawbacks too. Getting consensus is at the top of Dr. Mallory’s list of challenges—and this is true for UWH as well as for the larger UPM committee and boards that make strategic and operational decisions.

"We are highly motivated individuals,” says Dr. Mallory. He notes that only 5 percent of OB/GYNs are still in private practice in the country, so the trend to affiliate and partner or work for a hospital is almost universal. “We know this affiliation and partnership is valuable,” he says. But it’s still hard to get agreement. “We’ve decided to work with this organization to get things done, so we all have to learn to get along.”

While decision-making can be a headache, Dr. Mallory considers it a “growing pain” that is very different from the conditions doctors face who run their own practices. “But we all are learning to look at the greater good and think outside our individual practice,” he adds.

Mallory estimates that it takes two years to see results from the new platform and partnership, but he’s confident that they will pay dividends as long as the focus remains on the things that matter: “How best to take care of patients, how to save money for patients and ourselves, and how to make money as a business.”

Sounds like a recipe for success.

UWH participation gives Dr. Mallory and other providers the time and resources to make their practices more efficient.

As far as next steps goes, Dr. Mallory says he would like to see his organization grow. “Washington State is very diverse, geographically and culturally. However, our challenges are the same ones faced by all small practices,” he says. “We have a great model to help any stable practice survive, optimize, and grow in today’s business climate. Our affiliation with UWH has essentially taken the headaches out of running our practices, and permitted us to focus on the part we enjoy—seeing patients.”