Primary care is perfectly positioned to bend the cost curve. And that’s precisely what is driving consistent 45% growth of Fort Collins, Colorado-based Miramont Family Medicine, says CEO John L. Bender, MD, FAAFP. The multi-specialty group, with a heavy focus on family medicine, has an entirely different notion.
John L. Bender, MD, FAAFP, chief executive officer of Miramont Family Practice has a secret. His approach to family medicine will reduce healthcare costs overall, but it has also netted the practice a 45% boost in 2013 revenue. This slide show offers a photo tour of a practice that consistently doubles every two-plus years.
The Fort Collins, Colorado-based Miramont Family Medicine opened 3 of its 7 facilities in the last year. The practice has a 35,000-patient panel, and employs 80 including 12 physicians and 22 total providers. The practice uses a combination of private health insurance, Medicare, Medicaid and direct pay. Medicaid will represent 30% of the patient population by the end of 2014.
A key strategy for Miramont Family Medicine is to keep patients within its facilities. To accomplish it, the practice has developed a robust menu of healthcare services, combined with help from visiting specialists to provide everything from family medicine, outpatient general surgery, imaging to behavioral health, wellness and physical therapy.
Healthcare’s mantra has been to look at efficiencies and reduce spiraling healthcare costs. Bender believes that the hospital-led buying spree of family medical practices across the country will ultimately inflate prices. Independent family practices remain in a far better position to offer low-cost, quality care that keeps patients out of emergency rooms. However, most practices need to reinvent their processes and create far more sustainable systems to deliver affordable healthcare.
There is an art to efficiency, Bender explains. In fact, Miramont Family Medicine employs Lean principles to track every step in the practice and weed out as much waste as possible from their processes. This practice is all about utilization, developing highly efficient processes, measuring the results, and sharing them with the entire healthcare team.
Procedures remain a critically important part of the service mix. The practice contracts with visiting specialists to see patients at Miramont Family Medicine and coordinates care as a National Committee for Quality Assurance Level 3 Patient-Centered Medical Home. The delivery strategy is to keep patients engaged in their healthcare within the practice, and this approach creates a much easier environment in which to track, monitor, and better assess patient health.
Each of Miramont’s examination rooms is identical, by design. They are also stocked with the same equipment and devices, all located in the same place. The strategy saves time for physicians, and that is what it’s all about, Bender says.
While aesthetic services bring in $10,000 a month for the $7 million practice, the interest in this area is growing. Botox injections, chemical peels and the like can offer family medicine entry into additional direct-pay services. But there is something even more captivating about this area, Bender says. Aesthetics motivate patients to live a healthier lifestyle, and Miramont’s physicians are tracking the metrics to prove it.
The hospital built a dispensary off the waiting room and has a formulary of 160 different products. The idea is to make it convenient for patients and maintain prices comparable to area pharmacies. The dispensary is also stocked with various over-the-counter medications and medical supplies.
So, here’s the big secret. Running a successful family practice in 2014 is all about efficiency, Bender says. “What used to take us 20 minutes, we can now do in 10.” Most practices should conduct a thorough review of their processes, look for technologies to help streamline systems, and trim as much time waste out of the system as possible. Physicians, as practice leaders, also need to create a culture of self-empowerment and continuous improvement. There is no question that the financial and bureaucratic challenges facing family medicine are real, but Bender says there is no other group in healthcare so wellpositioned to transform the delivery of care. “I stopped apologizing for our prices. Our bills are hundreds of dollars, but they are not thousands of dollars like specialty care or tens of thousands like hospitals.”