Gloves come off in battle to hire docs

The battle for health-care allies is heating up.

Greeley Medical Clinic’s announcement earlier this month that it will align with Poudre Valley Health System in Fort Collins was a huge victory for PVHS in that battle. GMC is the region’s largest medical group with nearly 70 doctors.

Phoenix-based Banner Health, which owns McKee Medical Center in Loveland and has a contract to operate North Colorado Medical Center in Greeley, has long embraced the physician-employee model. Banner CEO Peter Fine said Banner has more than 600 employed physicians systemwide and that number is constantly growing among its 22 hospitals in seven western states.

“Find me a (medical school) graduate who doesn’t want to join a medical group,” Fine said. “It’s the way of the world; young doctors are moving that way. We needed something in our menu that included this option to draw in those young graduates.”

Fine said doctors and medical groups that affiliate with a health-care system can obtain the support and resources they need to build and equip their practices. He added that employed doctors “can spend more time practicing medicine and not worrying about the business part.”

Banner’s rival in Northern Colorado, PVHS, has generally espoused a more hands-off approach to affiliating with physicians and medical groups. And PVHS has generally benefited from that lighter touch, most recently in February when Family Physicians of Windsor decided to end an 11-year medical services contract with Banner. Family Physicians had been leasing space in a Banner-owned facility, and Banner canceled the lease when the doctors joined then-independent GMC. The physicians were welcomed with open arms when they moved across the street into PVHS-owned Windsor Medical Center.

“PVHS never once hesitated in committing their support to our physicians, our group, and ultimately our physicians’ patients,” GMC chief administrator Troy Simon said at the time.

Effects of health-care reform

But PVHS CEO Rulon Stacey said health-care reform is causing PVHS to become more aggressive and shift its philosophy toward the physician-employment model. That shift was most recently demonstrated by GMC’s move to an alignment with PVHS.

“Health-care reform is causing us to restructure how we operate in the future,” Stacey said. “I think health systems have to be more versatile than they were in the past. Now, the environment has changed a lot, so we’re offering (employment) as an opportunity to work more closely with Poudre Valley Health System.”

Stacey said he believes reform “is going to require true clinical integration” to bring down health-care costs. That means having relationships with as many specialty groups and physicians as possible to meet patient needs.

Even though both systems are now actively pursuing doctors and medical groups to join them, Banner is still taking the harder line. A new policy bars cardiologists not employed by Banner from practicing at NCMC as of April 19, and McKee Medical Center has ended its relationship with Heart Center of the Rockies, which operates out of PVHS-owned Medical Center of the Rockies in Loveland.

McKee now refers its cardiology patients exclusively to The Cardiovascular Institute, a Banner-owned business on the NCMC campus.

Banner CEO Fine said the company’s strategy is “all about hiring good physicians.”

“We now have a greater capability to coordinate care,” he said.

Fine said the battle for health-care employees in Northern Colorado began when PVHS opened MCR just a few miles from McKee in 2007. “It just highlighted the issue of competition,” he said. “It created a much more competitive environment.”

Meanwhile, PVHS’s Stacey said he’s more focused on clinical integration of services and even though there’s more emphasis now on employing doctors to accomplish that, he predicts it will be through a lighter approach than that being used by Banner.

“We think clinical integration is going to be mandatory, but employment is just one of the options,” he said. “We fully expect we’ll have 100 percent clinical integration but less than 50 percent (of those doctors) will be employees.”

That includes, Stacey said, PVHS-employed doctors retaining the right to send their patients to whatever hospital they choose – a decision that could send money away from PVHS facilities and coffers.

“It could happen,” he said. “But they would be providing the best care for their patients, and that’s the ultimate goal.”

Steve Porter covers health care for the Northern Colorado Business Report. He can be reached at 970-221-5400, ext. 217, or at sporter@ncbr.com.

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