Giving Voice to Independents

Office of Independent Providers links independent physicians with UH resources

UH Clinical Update | February 2024

In decades of delivering babies at UH Geauga Medical Center, Natalina Andreani, MD, has seen a credible and conscious shift in listening to the voice of the independent provider.

And this OB/GYN, who also serves as UH Geauga’s Associate Chief Medical Officer, is proud to practice at a hospital that allows independent providers to maintain their identity.

Nabil Madhun, DO, an endocrinologist in practice with his father on the west side, cares for generations of families facing Type 1 diabetes and thyroid conditions. He has welcomed the liaisons from the Office of the Independent Provider, who have given his two-person practice access to resources and the group buying power of the Physician Hospital Organization.

Both physicians find that independent providers have a voice at University Hospitals, where the playing field has been leveled to ensure that physicians both employed and independent have access to the benefits of affiliation with the University Hospitals health system.

Three Years in the Making

Sandhia Varyani, MD

The Office of the Independent Provider (OIP) was established in August 2020 to provide resources, networking opportunities and education to independent physicians. Most of the approximately 5,700 independent providers, whether primary care or in specialties like urology, orthopedics or infectious diseases, work in and around UH’s 11 community hospitals.

“They value their freedom but also want the benefits of working with a health system,” says OIP Director Sandhia Varyani, MD, FACOG, who regularly meets with independent physicians, as well as hospital and system leaders. “We want to make sure they’re better connected.”

Those 5,700 independent providers, joined with 3,273 UH-employed providers, comprise the UH Quality Care Network. This clinically integrated network is an ongoing effort to foster collaboration among independent and employed physicians to enhance quality and efficiency, and reduce the cost of care.

Of course, much of the focus of the past year has been to familiarize and train independent physicians on Epic. The new electronic medical record now contains all physicians in the Quality Care Network of independent physicians, not just UH-employed physicians.

Access to Resources

Independent providers working with UH also gain access to the Physician Hospital Organization, which assists with growth of practice revenue and reduction in practice expenses.

“We have all of the UH resources at our fingertips to make our practices flow nicely,” said Dr. Madhun, noting that the PHO can help doctors access group rates for medical and office equipment from exam tables to shredding services and even better rates for their own health insurance. “This has been absolutely incredible for us. We can be on our own and be sovereign but benefit from the rates that UH has negotiated.”

To keep independent providers informed about system initiatives, the OIP hosts a quarterly Independent Provider Council. This forum is designed to provide updates on systemwide initiatives, engage in discussion about changes affecting patients, and address provider concerns. The meeting takes places virtually on Zoom at 6 p.m. to accommodate the varying schedules of these physicians, many of whom – like UH counterparts – see patients at multiple hospitals, as well as rehab facilities and nursing homes. UH leaders like CEO Cliff Megerian, MD, and Chief Quality Officer Peter Pronovost, MD, have been among the guest speakers.

Dr. Varyani noted that hospital and service-line based quality meetings, such as the Mortality & Morbidity (M&M) Conferences, take place during usual business hours when many PCPs are going to nursing homes and other off-site facilities to see patients.

“It’s really leveling the playing field, being mindful of those independent providers who have a different workflow,” Dr. Varyani said.

The OIP also helps increase providers’ awareness of quality expectations and measures at UH.

“The OIP was established with the overarching objective of establishing UH as the provider of choice for independent providers,” Dr. Varyani stated in a recent letter to providers. “Our goals encompass enhancing access to our hospitals while ensuring the delivery of optimal patient care and patient experience.”

On Point

Rick Cicero, VP, Strategy and Partnerships, also is executive director of the PHO. Jerry Ribelli, Director, Independent Partnerships oversees two point people in the field who work with independent providers to assist their practices and connect them with resources: Jason Lansdale in the West Market and Rhonda Allen-Scott in the East and South markets.

“They’ve been very receptive at knowing what our issues are, as independent providers,” Dr. Andreani said of her OIP colleagues. “They’re more than willing to connect me with the right people, make arrangements for meetings and understand that we might face different issues than employed physicians.”

Most importantly, these independent physicians feel heard. In her 24 years as a practicing OB/GYN on the east side, Dr. Andreani has witnessed a culture change at UH.

“I utilize the hospital every single day, and I genuinely care about the success of the organization,” said Dr. Andreani. “A long time ago our presence felt understated. I don’t feel that’s the culture anymore.

“They’ve gained my trust.”