Our First Payer Agreement is in Hand!

By Douglas Tardio
President, CEO

As we celebrate a new year, and the entrance to a new decade, I wanted to share my thoughts on 2019 and my expectations for an incredible 2020 for United Rheumatology. For me, 2019 was a year of learning and building. Learning about your specialty and the nuances of care delivery that are in fact extraordinary. The incredible ties with patients over decades challenged at every turn by a system that has little if any understanding of who your practice is or what you really do for your patients. The fragmentation that we hear about in healthcare is more extreme in rheumatology than any other I have seen, and only UR gives practitioners the strength in numbers to improve the state of patient care. I have also spent time with Max, Lynette, Kelley, and many of you learning about UR, our core offerings, our strengths, (and weaknesses,) and what we can do to help more.

2019 was also a year of building.  Building off the past while leveraging old and new friends to create an incredible management team.  I am proud to say that within a year we successfully enhanced our team with Bill Moore (CTO), Frank Frenzel (Systems Engineer), Jim Albano (Operations and Payer Strategies), Pat Murphy (CFO), and Andy Concoff, MD (Chief Value Medical Officer). This new team has not wasted any time in learning how to work together and realigning the business to most effectively leverage each individuals’ strengths.

Our new team spent significant time on infrastructure.  Jim and Pat lead in the development of HR policies and procedures, standardized performance review tools, financial audit interfaces, and external legal reviews of regulatory compliance.  These items aren’t the most exciting, but necessary in today’s business climate.

We launched a new product offering for our members.  The Launch and Landing Pad.  If there is one thing that makes Max “unhappy,” it is to hear that a potential member sold their practice. “One fewer independent community rheumatologist makes us all weaker,” he would say.  And so, we sat as a team to look at all of the reasons why this might happen and with Lynette’s experience and leadership, we set out to build a team to help. Help practices that have lost a practice administrator.  Help practices leave hospital employment and go out on their own. Help Fellows learn there is an alternative to hospital employment.  Help with optimizing revenue cycle management.  The list goes on.  Our guiding principle is “No investment is too small… none is too large.”  Lynette and her new team have received an enormous amount of interest from our membership, and they are currently working with several practices.  In the first quarter, we will move this offering from a pilot to a standard business offering.

Our work with Pharma. With a new focus on our data assets from Bill Moore, the second half of the year saw significant resetting of the value of our data and our capabilities to mine our aggregated data assets to assist Pharma companies with clinical trial activities.  Additionally, we had the opportunity to develop a different type of dialog with several of these organizations that wanted to look at long term value-based offerings. Over the last several months we have worked with one of these organizations on an agreement for our members.  In the next two weeks, you will hear more about this exciting clinical program.

Finally an update on Payers.  When I joined as President, CEO last January, I set out as a goal to have every payer know who United Rheumatology was by the end of 2019.  Well, in all honesty, I am not sure we achieved this goal, but with the leadership of Jim Albano, we did make significant strides where it counts most. In October we held our national clinical conference with a focus on payers and new value-based models.  We heard from representatives from CVS Health, the former Chief Medical Officer at Cambia and Horizon BCBS NJ and from UnitedHealth Group Research and Development.  And while not all of our members were excited about what some of the value-based models looked like, this is a process.  A process of getting in the room and opening up a dialog so we can participate in the design, deployment, and gain share. We heard from Steve Catani, UnitedHealth Group R&D, and Andy Concoff, MD about the opportunity to join together in efforts around long term scientific research.

On the 27th of December 2019, United Rheumatology executed a Master Collaboration Agreement with UnitedHealth Group R&D.  The three (3) year agreement creates a framework to which UR will provide certain support, data, services, and technology in connection with one or more Research projects conducted by UHG R&D. An international panel of expert rheumatologists convened on January 8, 2020, to kick off this first of its kind effort to combine the strengths and expertise of each of these leading organizations all with an eye toward developing patient-focused, precision evaluation and treatment paradigms.

Yes, it has been a busy year and we end with incredible opportunities now in front of us heading into 2020.  We are now 625 rheumatologists.  It is unparalleled.  We are well on our way to 1,000.  You have heard from Max about how we got there, but I will reinforce that it is because of each of you.  Your support and the constant willingness to help.  As we develop new programs and new partnerships, we will need your help even more. In return, working together, we can set a new course for the delivery of care to your patients. One that places you at the epicenter of determining the definition of value-based care.

My best to all in 2020.

 

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