Mission Health's network to triple in size

ASHEVILLE — Mission Health Partners, the Accountable Care Organization of Mission Health System, is adding 550 specialists to its network next year, according to a statement released Thursday morning.

The network, which Mission says is the second largest in North Carolina, has 275 primary care physicians.

Mission formed Mission Health Partners in June 2014. This group is different than Mission Medical Associates, which represents the company-employed doctors. It was created by private physicians, the hospital, company physicians and community health centers working in a group. Mountain Area Health Education Center also had input. Doctors who join the ACO get to tap into a system designed to share data on patients across the population.

They give up some independence in that they have to follow standards of care set by the ACO and share data on patients. But they could be financially rewarded for meeting goals.

“In general, expanded networks offer the possibility for better coordinated care,” said Dr. Peter A. Ubel, a physician and behavioral scientist who also is associate director of Duke University’s Fuqua School of Business Health Sector Management program.

“But that all depends on whether the network develops things like electronic medical records that enable its clinicians to easily communicate with each other,” said Ubel, who added that he didn’t know the Mission Health Partners network well.

Mission’s patients could see their health costs go up, he said.

“Larger networks also give health care providers more negotiating leverage with insurance companies, which could mean that prices will rise and, therefore, that insurance premiums might rise, too,” Ubel said. “But whether that happens depends in part on whether the insurance companies in the same area are also consolidating.”

But another expert, Paula Song, said patients likely won’t notice any immediate differences.

Song is an associate professor of health policy and management at the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill.

Though patients could notice subtle improvements in care as their data is shared across the care continuum from primary care physicians to specialists to post-acute providers, Song said.

“The goal of an ACO is to better coordinate care for the patients,” she said. “That could also improve patient access to the doctors they need to be able to see.”

That’s because the care providers in the ACO are “more or less on the same page with what’s happening with the patient,” Song said.

The more streamlined system contrasts with what exists for many patients today: a fragmented situation in which “providers aren’t necessarily talking to each other,” Song said.

The Affordable Care Act encourages the creation of ACOs and allows Medicare to reward the groups with a share of the savings that result from improving care and reducing costs through efficiency.

Most reimbursements are based on Medicare and rules from the massive federal Center for Medicare and Medicaid Services, or CMS.

This push to create savings under the Affordable Care Act has spawned ACOs nationally.

The following practices are joining the ACO, according to the release:

Specialty Physicians and Practices:

• AllCare Clinical Associates, PA

• Appalachian Foot & Ankle Associates

• Asheville Arthritis and Osteoporosis Center

• Asheville Cardiology Associates

• Asheville Endocrinology Associates

• Asheville Eye Associates

• Asheville Gynecology & Wellness: Vicky M. Scott, DO

• Asheville Orthopaedic Associates, an affiliate of Mission Health

• Asheville Plastic Surgery: James M. McDonough, MD

• Asheville Pulmonary & Critical Care Associates, PA

• Asheville Women’s Medical Center

• Biltmore OB/GYN, PA

• Brosnan Eye Associates

• Steven L. Cahan, MD, PA

• Cancer Care of Western North Carolina, an affiliate of Mission Health

• Carolina Lung & Sleep at Pardee

• Carolina Mountain Dermatology, PA

• Carolina Mountain Emergency Medicine

• Carolina Ophthalmology, PA

• Carolina Spine & Neurosurgery Center, an affiliate of Mission Health

• Charles J. DePaolo, MD, PA

• Hendersonville Hematology & Oncology at Pardee

• Hendersonville Orthopedic at Pardee

• Hope Women’s Cancer Center, an affiliate of Mission Health

• Laurel OB/GYN, PA

• MAHEC OB/GYN Specialists

• McDowell Anew Aesthetics & Laser Care

• McDowell OB/GYN

• McDowell Orthopedics

• McDowell Pain Management

• Mission Children’s Hospital

• Mission Children’s Bryson City

• Mission Children’s Sylva

• Mission Fullerton Genetics Center

• Mission Infectious Disease Associates

• Mission Neurology

• Mission Psychiatry

• Mission Sports Medicine

• Mission Weight Management

• Mission Women’s Care

• Mission Wound Healing & Hyperbaric Center

• Moore Foot & Ankle Specialists, PA

• Mountain Area Pathology, PA

• Mountain Diabetes & Endocrine Center

• Mountain Kidney & Hypertension Associates

• Mountain Radiation Oncology

• Murphy Group Practice

• October Road, Inc.

• Pardee Center for Gynecology

• Pardee Diabetes and Endocrine Associates

• Pardee Neurology Associates

• Pardee OB/GYN Associates

• Pardee Surgical Associates

• Pardee Urological Associates

• The Pisgah Institute, PA

• Radiation Therapy Associates of WNC, PA

• Regional Surgical Specialists, an affiliate of Mission Health

• Rheumatology at Pardee

• Transylvania Women’s Care

• Victoria Urological Associates, an affiliate of Mission Health

• Western Carolina Women’s Specialty Center, an affiliate of Mission Health

• WNC Ear, Nose, Throat, Head & Neck Surgeons, PA

Primary Care Practices joining for 2016:

• All Kids Pediatrics

• Asheville Children’s Medical Center

• Asheville Family & Sports Medicine: Charles J. McGraw, MD

• Dry Ridge Family Medicine

• Haywood Pediatric and Adolescent Medicine Group

• Hendersonville Pediatrics

• Wellspring Family Practice