Merit IPA, a Savannah based independent physician association, hosted Commissioner Ralph Hudgens from the Department of Insurance, U.S. Representative Buddy Carter, and the Medical Association of Georgia CEO, Donald Palmisano Jr. This was the first time Savannah has hosted the DOI Commissioner and did so in front of a packed room at the Hoskins Building, just off the Memorial Health campus. 

Dr. Dan DeLoach initiated the forum with opening remarks, while Dr. Chris Wixon introduced Commissioner Hudgens and facilitated the ninety-minute discussion. Commissioner Hudgens led off the speakers with a series of witty remarks and straightforward points that spoke directly to those in attendance, the independent physicians. Issues discussed and questions from the audience included the department’s jurisdiction with insurance companies, the Commissioner’s intention and plan to assist providers in dealing with insurers, and how providers and payers can work together. With regard to the department’s responsibilities when it comes to dealing with state insurance companies, Mr. Hudgens responded, “We do not have the authority or jurisdiction to intervene between a provider and an insurance company. We do however; have the ability to approve contracts and amendments before they are distributed. Going forward, once approved by my department, the correct and full fee schedule must be sent to every physician in a practice.” Another popular stance taken by the Commissioner is bringing physicians to the table with the DOI as they approve proposed contracts. “A physician panel will be formed this year, with meetings in Atlanta and Macon. We will have a group of physicians from various areas around the state that will collaborate on issues that they will then bring directly to me.” 

Representative Carter was immediately questioned on how such reform can take place while affecting today’s independent physician practice the way that it does. This spoken in tone of today’s practice needing to be viewed as a small business. "I am a pharmacist, I have people leaving my store in tears, and they can't afford our drugs with unfair contracts. They have no choice; if they do not have coverage they won't pay $40. It is horrible what is going on with closed-networks. Access to healthcare is a big concern in south Georgia." When asked by the audience, who is overseeing these Health Information Exchange laws and how will we make an effort to see who has jurisdiction, Rep. Carter responded, "I'm all for state sovereignty. I agree we should handle as much as we can at the state level. Healthcare for whatever reason is under the energy and commerce committee at the federal level. Meanwhile, CMS is under education/workforce." He further added, "The attitude of the majority of the party is to not to amend ObamaCare to make it palatable. Republicans and democrats agree to get rid of the medical device tax. So, our solutions will come as a Republican alternative, not as an add-on simply to make ObamaCare palatable.” 

The third invited speaker for the event was Donald Palmisano Jr. CEO of the Medical Association of Georgia (MAG). He gave a spirited and thorough recap of other legislative action currently taking place in the state. In particular, Bill 158, in which he highlighted, “Senate Bill 158, the Consumer and Provider Protection Act, has recently been introduced by Senator Dean Burke, MD. This will reform patient and provider contracting in the managed care world. It will address, among other items, the dreaded rental networks and overall transparency in contracting. The Medical Association of Georgia, along with the medical specialties and allied health providers are working together on this bill. It was heard in the Senate Insurance Committee this week and will be studied over the summer.” 

It is fair to say that Dr. Chris Wixon of Merit IPA summed up the primary goal coming from this group of physicians: “From our perspective, our goals are fully aligned with insurers and there is no clearer partner for them than physicians. It is squarely our hope and intent, to bridge the gap with payers.” He further highlighted why such a forum was as more important now as ever. “Healthcare is more complicated now than it was 15 years ago,” Dr. Wixon stated. “It is no longer enough to be a great physician. We have challenges ahead as we pivot from a Fee for Service model to Fee for Value. This is why Merit IPA was formed, to provide independent physicians in our community with the infrastructure and support to take these next vital steps. We are launching clinical initiatives aimed directly at healthcare quality issues in Savannah. We aspire to be proactive, rather than reactive. Many of our clinics are establishing prevention and screening programs that are aimed at the early diagnosis and treatments of disease processes” “We believe these initiatives are not only in the interest of our patients, but also the third party payers which have assumed the financial risk for the health of our population. We understand the need to partner with insurers to reach a mutually beneficial and sustainable model that benefits our community.”