Ppo Contracts

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					Southern California PHYSICIAN May 2006
                                                  Magazine of the
 Imperial, Riverside. Orange, San Bernadino, Ventura and Los Angeles County Medical Societies


                                  BEST Practices
                 STRUGGLING WITH THE CHALLENGES of running a practice?
              You’re not alone. Doctors are looking for prescriptions to fix what ails
              their businesses. Meet six physicians who reveal the practice management
              strategies that keep their operations and employees growing and efficient.
                                                 By Dina L. Franks



          Michael Couris, MD, Vision Care & Correction of San Diego

                         Best Practice: Messenger Model
Ophthalmologist Michael Couris, MD, was tired of being shortchanged by bad PPO contracts. As a solo practitioner,

he had limited access to inexpensive legal advice on the terms he was agreeing to when he signed contract
agreements. So he decided to join an organization that would advocate on his behalf. He became part of Scripps
Mercy Physician Partners, a messenger model organization that assists solo and small group practice physicians with
PPO contracting.

“A messenger model entity acts as a negotiating team that goes to the insurance company and gets contracts based
on what a group of physicians have said they will accept,” Dr. Couris says. “If you are member of this group, you
tell them what you would accept as a normal, acceptable pay rate. After the entity aggregates these amounts from
each physician, it goes out to insurance companies and sees if it can get a decent contract. Then the entity comes
back to each individual physician who can either opt in or opt out of that contract.” If a physician chooses to
participate in an agreement, Scripps Mercy Physician Partners executes that agreement for the physician under a
limited power of attorney.

Scripps Mercy Physician Partners charges an annual membership fee of $1,200. But it is well worth the investment,
Dr. Couris says, considering how much physicians can earn from improved PPO contracts. “Many of the small
practices have pretty much whittled their overhead to as low as it can go,” Dr. Couris says. “Sure, there are some
tricks physicians can use here and there, but the real improvement in bottom line for physician practices is
improving revenue.” In fact, Dr. Couris is already seeing a return on his investment.

Since joining Scripps Mercy Physician Partners in 2004, his fees under commercial plan contracts have increased
anywhere from 10 percent to 40 percent….Additional organizations offering the messenger model include South
Bay Independent Physicians Medical Group in Torrance and Bay Area Preferred Physicians in Oakland “Using the
messenger model avoids the antitrust problems with negotiating contracts, and physicians get a professional
negotiator advocating on their behalf,” Dr. Couris says.

       Reprint courtesy of Southern California Physician & Distributed by Scripps Mercy Physician Partners

				
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