Clinic chains like ChenMed and Oak Street transformed how primary-care doctors get paid. Here's how they're tackling expensive specialty medicine.
found that specialty care delivered outside hospitals accounted for an estimated 17% of US healthcare spending in 2016, compared with primary care's 5%.ChenMed's Dr. Brian Gordon coaches Dr. Sally Azzo, a primary-care doctor, at ChenMed's Dedicated Senior Medical Center in Southfield, Michigan.In 2021, ChenMed, which serves Medicare Advantage patients with lots of illnesses, assembled a team of 10 doctors specializing in the types of care that cost it the most.
When primary-care doctors shoulder more responsibilities, ChenMed saves more money and collects a bigger profit margin. It's also better for patients, who avoid having to navigate more doctors and shell out more copayments for office visits, Tromanhauser said. ChenMed doctors can use Sitka, a virtual physician network, when they need advice from a specialist ChenMed doesn't have in-house. Sitka's CEO, Kelsey Mellard, said its doctors can consult on the 20 types of specialty care that people with Medicare use the most and usually answer messages in five to six hours.
Cano Health, a primary-care chain based in Miami that gets fixed monthly fees up front from health insurers to care for Medicare Advantage patients, has formed arrangements with some specialists in which it passes them a portion of its fees to take responsibility for a patient's cardiovascular care or eye care, for example.
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