Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, August 20, 1995 TAG: 9508210099
SECTION: VIRGINIA PAGE: C1 EDITION: METRO
SOURCE: SANDRA BROWN KELLY STAFF WRITER
DATELINE: LENGTH: Medium
That nucleus group, Blue Ridge Primary Care, has since grown into a corporation of 120 physicians who work in an area bounded by Martinsville, Abingdon and New Market.
The group is courting the likes of Carilion as a partner, its officials said Saturday. Blue Ridge also is talking with Columbia/HCA Healthcare Corp. and with a Durham, N.C., company, The Physicians Corp., said Dr. Jim Nuckolls of Galax, an internist who is the new chief executive officer for the group.
The primary care physicians are casting about for a company that is willing to give them an ``equal voice'' in patient care procedures and that can provide the $10 million needed for the information system to link the Blue Ridge members and collect their patient data, Nuckolls said.
Doctors paid a fee of several thousand dollars to join Blue Ridge, but that amount comes nowhere near covering capital needs, he said.
``What we're trying to do now is see which group's incentives are aligned most with ours,'' he said.
Blue Ridge Primary Care could end up with a variety of partners - venture capitalists, drug companies or information systems manufacturers, Nuckolls said.
The electronic medical records system is a priority so the group can move forward, said Nuckolls, a graduate of Davidson College and Duke University Medical School who also serves as managing partner of Blue Ridge Health Associates in Galax.
Nuckolls said his practice of nine physicians has electronic records, but it's an exception. Every practice must be outfitted with technology, though, because health care is moving toward pay by contract, he said.
``We see health care moving to where it will be paid for based on contracts with providers on a large basis - probably statewide, such as with the state workers now,'' he said.
The Trigon HealthKeepers plan that covers state employees is a perfect example of the need for good data on expenses and patient history, said Dr. Paul Page of Roanoke, medical director for Blue Ridge.
Page, an internist who has practices in Vinton and Boones Mill, is a participant in the Trigon plan. He said physicians get an average of $10 to $11 per month for every patient who's in the plan, but most of the doctors have no clue if these payments, plus any copayments, cover the expenses of treating those patients.
A doctor needs to know a patient's history of illness and need for physician care to be able to estimate if a payment is sufficient, he said. A doctor needs to know how many of his patients have illnesses that occupy the largest percentage of his time. Right now, that information is on paper charts in many offices, not easily accessible.
As long as only a few patients are on what is called a capitated contract, where the doctor is paid a set amount per person, it doesn't affect that physician's income; but as capitation increases, he has to know the makeup of his patients in a more detailed fashion, Page said.
Friday and Saturday, Page and Nuckolls met with New River and Roanoke Valley specialists to tell them about Blue Ridge Health Specialists, an individual practice association being established by Blue Ridge Primary Care.
By bringing specialists into a group, the primary care doctors will have a referral network that can be marketed, Nuckolls said. The specialists' group also is open to primary care physicians who don't want to merge into Blue Ridge Primary Care.
``This is the beginning of physicians working together,'' Page said. "It's change from mom-and-pop grocery store to Kroger."
Group dynamics already are at work. A new urgent care center of 10 Blue Ridge members that has opened in Radford is an example, Nuckolls said. The doctors share duties at the clinic, which operates after regular office hours at one of the physicians' offices.
A Blacksburg group is considering a similar project, he said.
by CNB