St. Francis Medical Center: Leading revolution in primary care

Just how healthy is the health care industry in Mercer County? Thanks to an innovative new alliance between many area primary care physicians and St. Francis Medical Center, it's getting stronger every day for more than 60,000 residents of Mercer County.

This exciting concept is part of a new "revolution" in the industry, one that is changing the way primary care physicians and hospitals work together in order to build a healthier community from the inside out.

In historical terms, a revolution is defined as a sudden, radical and complete change. In 1965, the federal government's Medicare program revolutionized the health care industry by creating a safety net for the elderly. In the '80s, Diagnosis Rated Groups (DRGs) changed the insurance industry yet again with standardized rates for medical diagnoses and procedures. Just a few short years ago, "Managed Care" was a revolutionary concept perceived as a threat to the financial health of major medical facilities, by empowering primary care physicians as a "gatekeepers" encouraged to keep costs low by limiting specialist -- and hospital -- referrals.

This most recent revolution, unlike others before it, affects our health care system from all sides, redefining the roles of doctors, hospitals and patients alike.

As managed care and capitated reimbursement programs, such as Health Maintenance Organizations (HMOs) place an emphasis on preventive care and treatment by primary care physicians, many major health care institutions are finding themselves re-evaluating their delivery of care to patients. The hospitals which directly seek to build healthier communities, like St. Francis Medical Center, will grow and evolve with these changes, by offering patients primary care services, such as family practice, internal medicine, obstetrics and pediatrics that are comprehensive and convenient to patients while strengthening relationships with individual patients, their families, and the community in general.

As more and more patients move into HMO care systems, doctors find themselves faced with increases in numbers of patients, as well as increases in preventative care visits which have been made much more affordable by these new programs.

As a result, patients may experience having to wait to get an appointment for a simple check-up. Additionally, without a referral from a primary care physician, they are often unable to seek the care of specialists for self-diagnosed complaints.

The solution has been found in an exciting new practice in primary health care: the primary care physician' s network. Simply put, this is a regional network of primary care physicians who affiliate themselves with a major area medical center to improve not only the quality of care their patients receive, but the way in which they receive it.

Under this system, the affiliate hospital provides a physician with support services which improve office efficiencies like the centralization of accounts payable, purchasing, standardization of patient specific documentation, and the increased use and support of technology. A Management Services Organization (MSO) handles automated patient scheduling, registration and billing functions, as well as a centralization of human resources and employee benefits.

The advantages of such an arrangement? The physician benefits from accessing the resources of a major medical facility and having more time to focus on patients, rather than practice management. The patient is assured the highest, most cost-effective, standard of care from a physician who is not preoccupied with paper work and burdensome business procedures.

By shifting business operations away from the practicing physician, more time is made available for attention to the patient. Through such a partnership with physicians and other health care providers, the hospital can build life-long relationships with patients in the communities they serve. The only practical change patients may notice is that more support services are available at the physician's office.

Most importantly, more and more physicians are recognizing that there is indeed strength in numbers. Strength to negotiate managed care contracts for patients as a group rather than as individuals. Strength to "team up" in larger, more conveniently-located offices that allow for increased waiting and exam room space and strength to assure patients that their care is being entrusted to a network of professionals backed by a leading hospital facility.

From preventive care and education through inpatient and outpatient services, to nursing home care, rehabilitative care or home health care. it is a natural evolution that hospitals are taking a larger role in providing an entire continuum of care.

Nowhere is this natural evolution proving more successful than with the primary care physician' s group established by Mercer County's own St. Francis Medical Center. Franciscan Family Care is the largest primary care network in Mercer County, currently consisting of 22 physician "partners," with plans for expansion to 35 physicians by the end of the year and 60 physicians by the end of 1998. Currently, Franciscan Family Care cares for over 60,000 family members, friends and neighbors.