How ODs and doctors find strength in numbers

How ODs and other doctors find strength in numbers

The largest-known integrated care arrangement between eye care professionals and other primary care providers is taking shape in Rhode Island.

Eye care was specifically included because of the crucial role it plays in overall health care.

In its quest to become a multispecialty independent physician association (IPA), the Rhode Island Primary Care Physicians Corporation (RIPCPC) has entered into a collaborative care agreement with a group of independent optometry and ophthalmology practices. As both parties explain, the goal is to better coordinate patient care.

Agreements such as these represent a growing model of integrated care that's sometimes referred to as "accountable care organization" (ACO)-type arrangements. This is when combinations of physicians, hospitals and in some instances health plans partner to coordinate care for patients to improve efficiency and health care outcomes.

Until last year, the IPA included only primary care medical doctors. Now, it is adding various specialty groups and other providers of primary care services, including eye care, behavioral health and cardiology.

Each group will be organized as a "pod," explains Stephen Montaquila, O.D., chair of the AOA Third Party Center's Executive Committee, who will be leading the IPA's eye care pod. His practice, West Bay Eye Associates, in Warwick, R.I., is one of IPA's participants.

Al Puerini, Jr., M.D., RIPCPC's president and CEO, says the primary goal of this agreement is to deepen relations between primary care providers and eye care professionals. "We need to communicate better and work together in more meaningful ways," Dr. Puerini says.

Eye care was specifically included because of the crucial role it plays in overall health care, Dr. Puerini says. "Many times it provides a 'window' into the patient's overall health by discovering specific signs that may indicate more systemic diseases."

A common example: Eye care professionals are key team members providing care for diabetic patients.

IPA may have largest number of ODs
The new arrangement appears to be setting a precedent for ODs who want to become more involved in ACOs or other integrated care models.

"The AOA is aware of other cases where ODs have gotten involved in ACO-type arrangements—but we are not aware of any that include this many optometrists," Dr. Montaquila says.

In its first two weeks, the eye care pod has already enrolled approximately 40 doctors—both ODs and ophthalmologists. But based upon interest at an initial meeting, "I feel that there is potential to enroll 80 to 100 providers," he says.

As Dr. Montaquila explains, a basic coordination-of-care agreement will exist between the provider and the IPA to start. However, "RIPCPC has demonstrated to payers that they are very good at achieving goals and generating savings, so we hope to apply their expertise in this area to eye care and to establish shared savings model contracts with payers," he says.

Practice obligations focus on three things: collaboration in patient care, communication and accessibility. "These pieces affect all of the providers involved. The goal is to establish protocols for true collaborative care ... taking better care of patients in a collaborative, cost-effective way," Dr. Montaquila says.

July 8, 2014

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