New physician group practices threaten a community health care system . . .
"Our health care community has undergone slow but steady transformation since The Tompkins Group helped us define the vision for IRMA and begin to make it a reality. They and their colleagues weren’t afraid to tell us the hard truths about what we needed to do. Although there has been no shortage of challenges, we went into this project with open eyes and we are making excellent progress."
Robert Kiely
President
Middlesex Hospital
Middletown, Connecticut
In early 1996, hospital executives and medical leaders of Middlesex (Connecticut) Hospital recognized that aggressive posturing by a new medical group, plus increasing managed care penetration and serious premium reductions, could threaten the viability of their community’s health care. Faced with an earlier failure to create a PHO and significant distrust among specialist and primary care physicians, hospital management and concerned physicians needed a new approach to "integration" that would avoid earlier mistakes.
Physician leaders, hospital management, and The Tompkins Group teamed up to define the needed capabilities for a strong local health care system, capable of enduring disruptive market forces. They postponed focusing on the system’s structure, governance and ownership, which had been key "hot buttons" to physicians in earlier integration attempts, until consensus had been reached on capabilities. "Form" was forced to follow "function."
In order to achieve wider acceptance of the leadership’s vision, the Tompkins Group facilitated expanded physician participation in the planning process by convening three "work groups" which focused on key functional areas: utilization and quality management ("medical management"), information systems, and HMO risk contracting. Additional expertise obtained by The Tompkins Group through its affiliate organizations, The Pace Group, Technology Management, Inc., and Barbara V. Scheil and Associates, expanded the depth of the project.
The end result of the initial planning process was the formation of a new health system subsidiary company, Integrated Resources for the Middlesex Area, LLC, or "IRMA," to provide medical management, marketing, physician education, communications, managed care contracting, and physician practice management, for the benefit of the community and IRMA’s customers and members. An abbreviated business planning process, which included the development of pro forma income statements using a market-based financial model, focused the leadership on the factors critical for IRMA’s success and established benchmarks for management.
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