Final Group Research Project, Wed. May 5 at 11:59 pm

You are associates of the The 410 Consulting Group .

GMU has purchased a 15-physician family practice physician group. They have two sites, one near the university in Fairfax, and a second in Manassas, VA

The Board of Trustees of GMU are new to oversight of a medical practice and have hired the consulting group to not only explain how things work, but also to advise them on efficiencies and the best way to operate departments and key functions in the practice.

Note that this will be a for-profit subsidiary of GMU, separate from the not-for-profit university. It is meant to be a profitable venture, with any profits going to the HAP scholarship fund.

Background /GMU Family Practice

1. A practice consists of two sites, in Fairfax and Manassas, VA.
2. Fifteen doctors, 10 male, five females
3. They had 50,000 patient visits in 202030,000 in Fairfax/ 20,000 in Manassas
4. Income Statement:

			Fairfax /GMU Family Practice
			Income Statement, FYE Dec. 31, 2020
Revenue
Collections from Patient Services					$7,000,000
Expenses
Wages and Salaries of Staff			2,500,000
Non-Personnel expense			1,500,000
Total Overhead Expenses			4,000,000
Physician Compensation			2,750,000
	Total Expenses				$ 6,750,000
	Net Income/Loss				$ 250,000

5. Participation with following insurance plans/managed care contracts:

Reimbursement for code 99213 (established patient visit)

-Blue Cross Anthem $65

-Blue Cross Care First of DC $55

-Medicare $60

-United Healthcare $50

-Cigna $55

-Aetna $70

-Tricare $58

The practice has been approached by Inova Health System about participation in its Accountable Care Organization based on the concept of Population Health Management

• Define in detail the concept of an ACO. How was the concept developed? Who are the participants?
• Define and Describe how Population Health Management is incorporated into an ACO.
• What are potential financial gains/risks to the participants in an ACO? Develop and review reimbursement models, financial incentives, including the role of value-based reimbursement
• Research an active ACO and describe how it is structured and how success will be measured by the medical groups participation.
• Interview a medical practice administrator currently participating in an ACO and his/her feedback and experience

DC Capital Health $54.50

The Board has identified the following issues as related to the practice and requested these projects for presentation by the 410 Consulting Groups teams at an upcoming special board meeting. Assume the Board is not familiar with details relating to your topic. A key part of the presentation will be an understandable explanation of your topic, as well as your solution in addressing the listed questions.