This column is part of a series of firsthand physician accounts that detail how AMA Health System Program members are moving medicine to support patient health and the medical profession.
Ten years ago, I was struggling with the increasing complexity of running a private practice, especially with value-based care looming on the horizon. That is why my colleagues and I took a leap of faith by joining with a then-fledgling Privia Medical Group, which is part of Privia Health.
In the decade since, I’ve come to see that moment as one of the most pivotal and rewarding decisions of my career. We could tell that Privia Health’s model—even in its infancy—was unique, intentional and promising.
Led by physicians and supported by experts, Privia championed autonomy and the patient-physician relationship. Over the years, the model has evolved in response to the changing health care landscape—without compromising the core principles that we were drawn to in the first place.
The best illustration of those values, which are deeply embedded in Privia’s model, is our consistent excellence in the Medicare Shared Savings Program (MSSP), where we’ve generated $690 million since I joined.
Here are the top six principles of Privia Health’s model that have driven repeated success and have positively impacted my practice as well as thousands of doctors and millions of patients.
Value physician autonomy, leadership
As I recounted on a podcast earlier this year, when weighing the pros and cons of joining Privia, a primary concern was that a partnership would diminish the autonomy, agility and decision-making that private practice affords us.
However, I’ve found the opposite to be true. I haven’t sacrificed control, operationally or clinically, at my practice. In fact, I and every other member have gained an opportunity to meaningfully contribute our input through the medical group as well as local and national committees.
This collaboration is perhaps the main reason why physician-led accountable care organizations like Privia have consistently ranked among the highest performing. We’re the ones in the exam rooms. We have skin in the game. We’re the bridge between policy and patient care. That’s the power of physician leadership, and Privia has understood this since its inception.
Learn how physicians’ desire for independence drives Privia partnerships.
A dyad fusing best of both worlds
While physicians have unique expertise and final word in Privia’s medical groups, we aren’t the only voices in the room. Adjusting to value-based care affects our administrative operations as much as clinical pathways.
For that reason, all of our regional, recurring physician-organized delivery (POD) meetings include subject-matter experts from population health to coding and everything in between. Their perspectives highlight areas for improvement that we, as doctors, may overlook in our everyday practice.
All-in-one for simplicity, integration
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Outside of POD meetings, Privia’s comprehensive administrative support is a key facet that drew us to their model. Why haggle with different vendors for your billing, IT and EHR when you can bundle everything together with an all-in-one partner?
Their support teams also offload tasks and help identify realistic next steps to help drive success in MSSP in three key ways. They are:
- Fortifying foundations. Before venturing into value-based care, it’s critical that you nail the fundamentals of your practice, such as revenue cycle management, coding and contracting.
- Educational bandwidth. Value-based care has a steep learning curve. A partner can reduce the time and energy you allocate to administrative work so you can instead focus on adapting to the new payment model and dedicate more time to patients.
- Leveraging data. Privia’s analysts extract and distill data from multiple sources, including our EHR and Centers for Medicare & Medicaid Services databases, to guide our initiatives and, whenever possible, provide actionable insights at the point of care.
Balance collaboration, objectivity
Overwhelming, disorganized data makes value-based a nonstarter for many physicians. While accessing accurate data is essential to MSSP, how that data is presented and utilized is equally important.
Our POD meetings broadcast all participants’ metrics transparently and objectively. You might think this leads to pointing and wagging fingers at low performers, but that’s absolutely not the case. Instead, it fosters constructive conversations, knowledge-sharing and collegiality. All of which stimulate engagement and connection that help break down silos, combat burnout and enhance the group’s performance.
Multispecialty for end-to-end quality
To truly break down silos, it's essential that specialists—who to date have largely been excluded from value-based care—work closely alongside and in harmony with primary care physicians. MSSP and other outcome-based contracts reward 360-degree, highly coordinated care, and specialists are pivotal in patients’ holistic journeys.
Again, this teamwork is encoded into Privia’s model, which welcomes physicians of all types to PODs and embeds tiered referral pathways into our tech platform to foster collaboration. This feature not only helps ensure we’re guiding patients to the most high-quality, cost-effective specialty care physicians but also enables a more seamless exchange of information between specialists and primary care to show a detailed profile of each patient and avoid duplicative, costly, wasteful services.
A proven, realistic partnership
Sometimes, when at a conference or chatting with peers, I’ll hear someone mention the “value-based future of medicine.” Value-based care is here, now. It has been for years, as proven by Privia’s generating savings in the MSSP for 10 consecutive years. Certainly, as Medicare pushes to enroll every beneficiary in a value-based arrangement by 2030, we’ll see greater participation.
But what does that mean for doctors today?
Even if you’re not already involved in value-based care, you can—and should—begin now, catch up, get ahead and do so without radically, immediately overhauling your practice of medicine. You just have to get started.
One of the main drivers behind my decision to partner with Privia was their gradual, methodical progression. They support fee-for-service contracts, so there’s no need to go all-in on value-based care. They meet doctors where they actually are in the transition to these arrangements, reinforce foundations, provide a road map, then move forward together. It’s possible to go from zero experience in value-based care to upside bonuses to potentially lucrative models that require downside financial risk quickly and confidently. The key is to start now.
The challenges that led me to partner with Privia Health a decade ago are still present in health care. You could even make the case that they’ve intensified. Employed physicians further outnumber private practice physicians. Administrative burden has exacerbated burnout. Value-based care has grown more complex.
However, I feel more comfortable knowing that I’m supported by a team of experts and a community of physicians. This sense of belonging and actionable optimism is what we need to advance value-based care and, with it, improve the lives of our patients and the state of health care.
Learn with the AMA about ways to improve value-based care data sharing and advance value-based care with alternative payment models in Medicare.
Dr. Taweel is the chief medical officer of Privia Medical Group—Mid-Atlantic, which is part of Privia Health, an AMA Health System Program member.
