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Internet Use as a Survival Strategy

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Internet Use as a Survival Strategy

An IPA aims to use the Internet to proactively manage the health of its patients.

By Steve McDermott

In keeping with the fluid nature of the Internet, its uses have changed dramatically within the past few months. The real long-term benefit of the Internet, it seems, is to be found in the business-to-business sector. At Hill Physicians, San Ramon, Calif, we are using both the business-to-business capabilities and the business-to-consumer benefits of the Internet as part of a strategy that is already improving our methods, efficiency, and long-term viability as an enterprise.

We are using the Internet to change the functionality of the interaction between our private independent physicians, our company, and our enrollees. It is important to understand the business context within which this is taking place: Hill Physicians is the largest independent practice association (IPA) in the United States and the largest capitated medical group in California, with 2,500 physicians, 1,600 offices, 20 affiliated hospitals, and 400,000 managed-care enrollees in northern California alone. The region served by the IPA is the size of New England; unlike Los Angeles, the home of managed care, northern California looks, demographically speaking, much like the rest of the United States. Medicine is practiced in small offices. For example, a large group practice within Hill Physicians might consist of 12 physicians, and a typical office practice would have two to three physicians working in it. This is classic throughout the United States.

During the past 30 years, the day-to-day way in which a physician practices medicine does not appear to have changed at all. We are still trapped in the fee-for-service physician-patient model, in which the physician must see every patient physically in order to be paid. That is a trap that has become a treadmill. At Hill Physicians, we anticipate unlocking that trap and making changes, allowing physicians to do more than just react face-to-face to patients. Our intent is to allow physicians to manage the health of their patients proactively.

Hill Physicians has a large enrollment that continues to grow. Northern California is similar to New England or the mid-Atlantic states in that it includes three or four major metropolitan areas within a wide geographic region and also incorporates suburban and rural areas. As an entity, the IPA is more successful in areas in which the local physicians have tried to organize and have gone bankrupt; they actually appreciate our coming in and helping them to get organized in a more disciplined way.