Texas doctors band together to fight for independence

When physician groups in the Dallas-Fort Worth area started to feel the pressure of value-based contracts, they realized quickly that banding together was the best way to maintain autonomy while staying competitive in a changing market.

Their solution was a physician-led clinically integrated network, and what started as an alliance of a couple hundred independent physicians has ballooned to more than 500 primary care and 600 specialists caring for more than 75,000 patients under the TXCIN (pronounced “Texan”) moniker. At its July 1 launch, TXCIN was associated with 1,135 practices.

Membership is open to all physicians in North Texas.. By signing up, members agree to use a common technology platform that pulls data from electronic health records and other systems into a common format, tracks data and helps the group improve care across the organization. Performance metrics, physician coordination and a commitment to improving care across the network are requirements for all members, but the technology platform integrates with existing systems, and improving patient outcomes generates more interest from insurance providers looking for the most cost-effective delivery model.

While members must follow the network’s rules, physicians remain independent. “Doctors get to choose which contracts to get into,” says Jim Walton, DO, MBA, president and CEO of TXCIN. “There is peer review, but we are governed by independent physicians who had to make similar decisions to participate in value-based contracting like our members.”

The group focuses on cost reductions using tools and clinical guidelines but does not participate in rate negotiations or reimbursements – meaning it does not require regulatory review. Physicians from all types of practices are eligible to join.

John Robert Bret, MD, a cardiologist with HeartPlace and member of TXCIN, says the integration of independent physicians is a natural evolution. “There’s a battle for healthcare dollars, and if there is not a large enough army behind you, it can be difficult to compete,” says Bret. “Joining a group like TXCIN is not an absolute for survival, but it makes us relevant in the marketplace.”

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