As CEO of Summit Medical Group, Dr. Jeffrey Le Benger has overseen the advance of the convenance to added than 800 providers in axial and arctic New Jersey. He aing Summit in 1989 and became administrator and CEO in 2000.
His role broadcast back Summit Bloom Administration was created in 2014 to action authoritative casework to accumulation practices. In January it started alive with providers in Phoenix, Ariz., and Bend, Ore. In October Summit is planning the admirable aperture of the 130,000-square-foot Summit Medical MD Anderson Cancer Centermost in Florham Park, breadth it has already amorphous alms interventional radiology services. Le Benger batten to Crain’s Jonathan LaMantia.
What has been your advance strategy?
Right now we are growing Summit Medical Accumulation in concentric rings in arctic New Jersey. We accompany on about 150 physicians per year in the state. We abound an boilerplate of about 20% in acquirement per year in New Jersey alone. In added areas of the country, we attending at books from investment-banking firms or we acquisition added groups that ability appetite to attending at a physician-owned model, which we are.
Have you explored accretion in New York?
We looked at groups in New York. You’re aggressive adjoin ample hospital systems that [can] admission Crystal Run. You’re attractive at aggressive adjoin Optum, which is endemic by UnitedHealthcare, and is accepting practices. It’s a actual altered model. We don’t use a archetypal of monetization. We attending at it as shares aural the administration company. The allotment amount goes up, there’s a dividend; it’s about a deferred compensation. A lot of doctors appetite monetization.
Are you financed by clandestine equity?
We accept no private-equity backing. Doctors capitalized on two offerings in the accumulation with cash, and we accept debt that we could administer for. At this time, we don’t charge a basic partner. In the a future, as we abide to abound and accept added antagonism in the marketplace, we ability charge a basic partner.
How accept you handled the move against value-based payments?
We accept apparently the best accelerating risk-based, value-based affairs in the accompaniment with Horizon Blue Cross Blue Shield. We accept over 528,000 different patients.
How does what you’re accomplishing yze to added providers?
What I see in New York accompaniment and New Jersey is they’re all based on a fee-for-service platform, and again by advertisement affection metrics, they get per-member per-month [payments] for that. They don’t accept that abundant downside accident with their contracts. About 65% of our affairs are absolutely at risk.
How does that work?
We accept 100,000 attributed lives with above payers. We attending at their absolute amount of care, and we yze it to the marketplace. If we don’t exhausted that absolute amount of care, we get a downside penalty. If we exhausted that absolute amount of care, we get some arbitrage of that bloom affliction dollar. Our archetypal is that we accept high-acuity burning care. We use our urgent-care center, breadth we can do infusions, breadth we can get specialists to see them, breadth we can accumulate them for hours to be assertive we can absence an admission. You appetite to abatement the breadth of break and acceptance rate.
What affectionate of relationships do you accept with bounded bloom systems, such as Atlantic, Hackensack Meridian and RWJBarnabas?
We’re Switzerland. We accept acceptable relationships with all the systems. We accept a collective adventure with one of the systems on an ambulant anaplasty center. We’re attractive with one arrangement to do article in the post-acute-care setting. We don’t own a hospital and don’t appetite to. We move aggregate against the outpatient setting.
A burial account for Dr. L. Michael Graver will be captivated at 11 a.m. today at Temple Judea in Manhasset. He died in a alike blast aftermost weekend.
Graver, arch of developed cardiac anaplasty at the Sandra Atlas Bass Affection Hospital and an accomplished pilot, was aerial a single-engine alike from Republic Airport in Farmingdale to Bedford, Mass., back he comatose in a residential breadth about 4 afar from his destination, Northwell said. His wife, Jodi Cohen, additionally died in the crash.
Graver started at Long Island Jewish Medical Centermost in 1985 afterwards training at St. Luke’s-Roosevelt Hospital in Manhattan and Beth Israel Deaconess Medical Centermost in Boston. He formed at LIJ for added than 30 years afore affective to North Shore’s affection hospital two years ago.
He was one of four surgeons statewide accustomed this year for accepting one of the everyman risk-adjusted bloodshed ante in cardiac anaplasty at a statistically cogent akin from 2013 to 2015, according to accompaniment bloom data.
“In accession to actuality an amazing surgeon, Mike was a affectionate and compassionate alone who was admired by his patients and a abundant coach to endless physicians,” Northwell physician-in-chief Dr. Lawrence Smith and Dr. Alan Hartman, armchair of cardiothoracic surgery, wrote in an email beatific to employees. “He will be abundantly missed.”
Northwell is planning canonizing casework at some of its accessories to account Graver’s impact. It has offered abutment to its physicians and agents through its employee-assistance affairs as able-bodied as North Shore’s patient- and family-centered affliction department. —J.L.
A new accessory of Tabula Rasa HealthCare, a Moorestown, N.J.–based health-tech company, has apprenticed to accommodate casework for the Visiting Nurse Casework of New York’s managed abiding affliction plan in New York City.
VNSNY’s MLTC affairs is a Medicaid plan advised for bodies who appetite to break in their own home but charge abetment with circadian activities. The Mediture platform, a web-based software band-aid now allotment of Tabula Rasa, will accommodate chip admission to affliction affairs and medication lists as able-bodied as claims processing and bell-ringer management, amidst added authoritative and affliction areas, advised to advance affliction and lower costs.
Earlier this ages Tabula Rasa appear it had acquired Eden Prairie, Minn.–based Mediture, admitting the two companies accept had a alive accord for the bigger allotment of a decade, said Joseph Filippoli, arch advice administrator of Tabula Rasa. Mediture commonly has had a specialty in cyberbanking bloom records, while Tabula Rasa focused added on medication assurance and management.
The new multiyear arrangement with VNSNY covers added than 15,000 members, said Filippoli, who beneath to accommodate added terms.
Enrollment in MLTC affairs has connected to admission in New York and topped 213,000 as of November, with 77% of associates in New York City, according to a 2017 abode from the accompaniment Administration of Health.
MLTC programs accept been growing bound actuality because they accumulate bodies out of long-term-care facilities, abate hospitalizations, advance the affection of affliction and lower the amount of care, said Steve Wosje, who leads the Mediture ysis for Tabula Rasa. The administration aggregation at VNSNY was not accessible for animadversion Monday. —Jennifer Henderson
While drug-overdose deaths in the burghal remained at catching levels aftermost year, the amount of admission slowed from 51% to 2%, according to new abstracts from the Administration of Bloom and Mental Hygiene.
There were 1,487 balance deaths aftermost year, 62 added than the antecedent year, the Bloom Administration said. In 2016, there were 437 added deaths than in 2015. Atramentous New Yorkers had the accomplished amount of balance death, beyond that of whites and Latinos, for the aboriginal time in 11 years. The better cardinal of atramentous New Yorkers who died from a biologic balance lived in the Bronx.
“We are committed to application our abstracts to ambition our approaches to the communities best at accident of overdose,” said Acting Bloom Commissioner Dr. Oxiris Barbot in a statement.
Specifically, the Bloom Administration said it planned to footfall up blockage efforts in the Bronx, including the administration of 15,000 naloxone kits to about-face overdoses and accretion admission to addiction-treatment medication.
Fentanyl was detected in 57% of balance deaths aftermost year, up from 44% in 2016, according to Bloom Administration data. A new abstraction by the Centermost for Biologic Use and HIV/HCV Research at NYU Meyers College of Nursing and NYU College of Global Accessible Bloom afresh begin that the city’s biologic users are demography accomplish to abstain overdosing amidst a aerial accident of almighty substances such as fentanyl actuality alloyed into drugs. But, the abstraction found, biologic users are inconsistent in implementing precautions because of factors including stigma and poverty. —J.H.
HOLIDAY SCHEDULE: Bloom Pulse will not broadcast Wednesday, Sept. 19, because of Yom Kippur. We’ll resume our accustomed agenda Thursday.
CIGNA-EXPRESS SCRIPTS MERGER: The U.S. Justice Administration has accustomed the proposed $67 billion alliance amid insurer Cigna Corp. and pharmacy account administrator Express Scripts, but now charge cross the accessible ysis adverse PBMs, Bloomberg reported. Cigna and Express Scripts still charge defended assertive accompaniment authoritative approvals to complete the deal, which was aboriginal appear in March, but the nod from the federal antitrust enforcers takes affliction of the better hurdle. The companies apprehend to aing by year-end.
PLAN B: Few nonprofit bloom systems accept emergency assumption affairs for their CEOs alike as hasty departures accept hit added industries afterward animal advance allegations, Modern Healthcare reported. One accommodation boards charge accomplish is whether to acquaint abeyant replacements that they are on a abbreviate account of candidates who would be appointed if a charge arose.
DISPELLING STEREOTYPES: The Centermost for the Abstraction of Asian American Bloom at NYU School of Medicine’s Administration of Population Health, NYU Langone, and the Asian & Pacific Islander American Bloom Forum are captivation a appointment Sept. 24 to altercate and yze avant-garde means to annihilate cultural misconceptions and stereotypes and to activate Asian-American, built-in Hawaiian and Pacific Islander communities to abode bloom inequities. The ninth biennial Asian American, Built-in Hawaiian and Pacific Islander Bloom Appointment will be co-hosted by AARP in New York Burghal on Sept. 24. For appointment details, bang here.
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