By Tara Bannow

The Bulletin

Bend Memorial Clinic is betting on a New Jersey-based practice management firm to turn around its slumping finances.

BMC, Central Oregon’s largest multispecialty physician group, is bringing Summit Health Management on board to take over components of its operations and scour the organization for areas of potential cost savings. But don’t expect to hear a New Jersey accent when you call to make an appointment.

“I don’t want to give people the impression that that means suddenly all the jobs are being transferred to New Jersey,” said BMC CEO Dr. David Holloway. “That’s not what’s happening. We’ll continue to have people here in Bend doing the jobs that they’re doing today.”

BMC has already cut 100 positions through attrition from its peak about 15 months ago, and the current move is not designed to cut more jobs, Holloway said. BMC currently employs 568 people, including 84 physicians.

The costly adoption of the Epic electronic health records platform in 2015 dealt a significant setback to BMC’s bottom line. The provider operated at a slight loss in 2016, but finances improved in the first half of this year, Holloway said.

The two parties signed a letter of intent Monday and plan to have a final agreement in place within eight weeks. Under the contract — which Summit’s CEO said will last 20 years — BMC’s 37 physician shareholders will retain ownership.

Dr. Jeffrey Le Benger, the CEO of Summit Health Management, said he believes physicians should own their own practices, as they do in the medical group he also heads.

“They have to have skin in the game,” he said. “They have to feel that they are the drivers of their own group.”

Under the new model, Summit will send its experts to BMC to assess where improvements can be made, whether that’s in billing, contracting with insurers, patient access, physician productivity, the quality of care delivered or administration, Le Benger said.

One area Summit will definitely help: ensuring BMC is using Epic to its full capability, he said. Le Benger said he just returned from a meeting with Epic’s CEO in Wisconsin, where they discussed the implementation at BMC and how the practice can optimize the platform.

Le Benger is aware of BMC’s financial struggles and said Summit will turn that around by creating efficiencies and growing volume.

“We’re going in there to rectify this and move forward and stabilize and to grow the Bend medical clinic to the prominence that it has and that it should have,” he said.

Officials with BMC and Summit emphasize the partnership will free up time for doctors to focus on what’s most important — patient care — by relieving them of some of their time-consuming administrative duties. For example, some doctors also serve as section chiefs, which means they take part in operational decisions, said Dr. Russell Massine, BMC’s chief governance officer. In the future, Summit would make those decisions, with approval from BMC’s eight-member board of directors, he said.

Andrew Swanson, vice president of consulting and business development for the Medical Group Management Association, has examined partnerships like this one. He said one way Summit could try to improve BMC’s bottom line is by increasing the number of patients its providers see.

Swanson also cautioned that doctors should maintain at least some involvement in the practice’s operations.

“It’s striking a balance,” he said, “and if Summit can help strike a better balance, if their balance has gotten too weighted or overly weighted on the administrative side, then maybe they can help with that.”

Another way a firm like Summit will help BMC is to examine how it bills insurance carriers, an area that, if improved, can typically generate profits, Swanson said.

“Summit has experts sitting in New Jersey who understand how a claim gets filed so that it isn’t denied,” he said. “If you reduce the amount of denials and you accentuate the amount of properly coded claims … they can tap into those additional dollars.”

Health care is increasingly shifting away from compensation based on the volume of services in favor of the quality of services and improving the health care of populations over time. Summit has a lot of experience with helping practices use data to make sure they’re managing their patients’ health and getting reimbursed by insurers based on improving quality, Holloway said.

BMC did not involve employees in the decision to partner with Summit. Instead, the practice hosted a handful of town hall meetings with its company shareholders to learn what they wanted to see in a partnership. Ultimately, the decision was a unanimous board vote, Massine said.

At a time when physician-owned practices are commonly bought by large hospital systems, Holloway said it was important to BMC to retain its physician-owned structure.

“The culture is outlined around this physician-directed, physician-led organization, and we think that is the best way for health care in the future,” he said.

Had BMC been purchased by a hospital system, it would have meant less control for patients and providers alike, said Swanson, of the management association. If it was a system with hospitals in Portland or Eugene, patients likely would have been forced to travel there for in-network hospital services, he said.

“That’s important for the community to know that this doctors’ group is trying hard to stay independent for their best interest in cost and choice,” Swanson said, “and that’s what you lose in a hospital system.”

— Reporter: 541-383-0304,