More than 300 physicians practicing at East Jefferson General Hospital have signed onto Gulf South Quality Network, the state’s first clinically integrated physician network and one of the latest efforts to improve healthcare quality.

The Federal Trade Commission set up the Clinical Integration (CI) concept in the mid-1990s.

Gulf South Quality Network (GSQN), established in mid-2010, is a way to bring physician practices into the quality equation, said Dr. Jeffrey Griffin, chairman of the network.

“The concept is that if you can demonstrate your commitment to improving quality, they (the federal government) will let you negotiate in a way that you can be paid for that quality,” Griffin said. “So it’s a real win-win for the docs and the community, the patients, the patients’ employers, everybody.”

Gulf South Quality Network is physician-managed and physician-operated. The network is designed to improve the quality of care, manage healthcare costs and use clinical information technologies to coordinate care.

In order to be part of the quality network, physicians must commit to submitting and reviewing patient data, Griffin said. GSQN will encourage its member physicians to look at the data at least once a month, but the goal is to do that every two weeks if not weekly.

Through GSQN, that information is fed into a registry, analyzed and compared to the 200-plus standards set up by the network’s quality committee, Griffin said. Each specialty has five to seven measures.

“If they’re not meeting standards, they can go into this database and see where they’re falling out and figure out what they have to do to get to an acceptable standard,” Griffin said.

If doctors can’t get there on their own, they can work with other physicians who are meeting the quality standards, Griffin said.

“One of the benefits of the community is that the way we have collected data in the past has not been very transparent,” Griffin said. “This is totally transparent. Each doc can go in and look and see where he falls out.”

That’s important because the Centers for Medicare and Medicaid Services and many others have found there’s an incredible amount of variation in healthcare costs and outcomes, Griffin said. And those outcomes don’t always correlate to the cost of care.

The federal government wants to eliminate as much of the variation as possible and pay for quality, Griffin said. As the network learns to set benchmarks and sees the results of those decisions, best practices will evolve.

Patients will get better results, and doctors, a pretty idealistic bunch, will be pleased with that, he said.

Four months ago, the network hired Bill Bopp, who had run similar networks in Texas and Indiana, as its president. Bopp said the improvements in quality of care happen quickly; physicians don’t want to be left behind by their buddies.

Griffin said 65 percent to 70 percent of East Jeff’s physicians have joined the network.

 “It’s going to be an enormous thing that we’ve got this many docs doing this. We’ve got 340, 350 docs doing this in one of the major hospitals in New Orleans,” Griffin said.

East Jefferson is largely a community of small, independent physician practices, with maybe 50 or 60 employed physicians, he said. Physicians who join the GSQN still run their practices; all the network does is help look over their quality.

Griffin said putting together the network was complex, time-consuming and cost in “the major seven figures,” with much of that expense technology.

The process began nearly four years ago, when East Jeff physicians established a board of managers for the network, Griffin said. Part of the process required the network’s organizers to appear before the Federal Trade Commission. The agency had to sign off on the arrangement, which allows network members to make price agreements that might ordinarily be considered a violation of anti-trust law.

The end result of all that work is that doctors collectively created a product that they can sell while maintaining their independence and autonomy, Griffin said. The clinically integrated network has already drawn interest from large employers and health insurers, as well as some Medicare Advantage plans.

Griffin said 65 percent to 70 percent of the physicians practicing at East Jefferson are taking part in the quality network.

An additional benefit of participation is that the documentation allows doctors to qualify for the Physician Quality Reporting System payments, Griffin said. At the end of the year, the network can hand physicians a letter that they send in to CMS, and the agency will send them the PQRS checks.

Down the road, Griffin said he hopes the data analysis will become sophisticated enough to determine why some patients end up in the hospital while others don’t, and to prevent unnecessary hospitalizations.

The goal is to get patients that do enter the hospital out more quickly with a well-organized plan that keeps them from having to return, he said.

“You’re not going to save money unless you just really make this thing efficient. The whole point of this, and the reason they’re willing to pay us for quality is to save money,” Griffin said.

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