Physician Integration 101

physician integration

Whether you’re looking to join a practice, collaborate with a hospital, or pool resources—it’s important to know your options for physician integration.

Here’s a primer on physician integration to help determine the right solution for you.

Common Reasons Physicians Seek Integration Opportunities

If you’re an independent physician, you might be wondering why other independent doctors would seek to integrate with a medical group.  Here are some of the common reasons providers come to MED3000 for integration assistance.

  • Financial Support
    • As healthcare becomes more and more complicated (and requires more investments to keep up with insurance, comply with reporting requirements, etc.) integrating with an existing practice or hospital can reduce the financial burden on physicians.
  • Risk Reduction
    • Larger practices can provide a type of “safe harbor” for physicians that reduce overall exposure.  Risk reduction programs, comprehensive insurance, compliance policies and more can reduce the risk of practicing medicine and offer protection should claims arise.
  • Profit
    • Integrating into an existing practice or hospital gives physicians a chance to earn bonuses from Medicare or electronic medical records (EMR) that are often out of reach to sole providers.
    • Taking advantage of the large scale of a hospital or medical group can also increase profits by reducing costs.

Types of Physician Integration

1 – Hard Integration with a Practice

A physician who joins an existing medical practice is an example of a hard integration.  Doctors who are relocating or leaving residency might choose this option, rather than establishing a practice from the ground up.

While details vary, in most cases a physician can buy into a practice when looking to integrate.  This process might ramp up slowly so both parties can decide if they are a good fit before making a full commitment to join together.

In this scenario, physicians are able to begin seeing patients quickly as they benefit from the practice’s already-established processes.

2 – Hard integration with a Hospital

In this instance, a physician is employed by a hospital system or a hospital-owned practice.  In addition to joining the hospital payroll, physicians can benefit from referrals and participate in value-based care models.

While it may appear that this type of integration is becoming more common as a result of the Affordable Care Act and economic conditions, a study conducted by Rice University’s Baker Institute determined that the integration levels between hospitals and physicians is more complicated.  

The study recognized that tighter integrations among hospitals and physicians increased between 2008 and 2013, and looser forms of integration decreased during that time. The study also found that many hospitals decreased their physician integration levels as well, leading the researchers to determine that “the observed overall shift to tighter physician-hospital integration does not have a consistent pattern and may be more complex than previously expected.”

3 – Soft integration

For doctors looking for some of the benefits associated with groups – such as sharing best practices or negotiating power for benefits – without joining a practice or hospital, there are some soft integration options.

  • Accountable Care Organization (ACO) – a group of medical care providers working together to coordinate care for a particular patient population. 
  • Independent Practice Association (IPA) – an entity owned by independent physicians to reduce overhead or pursue business ventures.
  • Open or Closed Physician-Hospital Organization (OPHO or CPHO) – Provides administrative services, manage ambulatory facilities for physicians or contracts with select physicians.

At MED3000, we can guide physicians and practices through practice integration and ACO facilitation. To learn more about your options, contact our experts today!