As president and CEO of the Federal Reserve Bank of San Francisco and a member of the central bank’s Federal Open Market Committee, Mary Daly is a quant among quants. Like most economists, particularly those who work at the Fed, Daly lives with and loves the numbers.
Her job is an ongoing group debate about the interpretation of endless charts and graphs. Unemployment, consumer sentiment, shipping containers from China, soybean production from the Midwest, the price of gas…Daly and her colleagues digest the data in attempt to sense the direction, speed and future of the economy.
But she has a special advantage, a unique data source that gives her insight most classic economists do not have. She leaves her office and goes around the nine western states covered by the San Francisco district and actually talks to people. She tells stories from her road trips in her podcast, ‘Zip Code Economies.’ A Fed economist telling stories from the ground? What a concept.
My week put me in multiple interesting conversations with independent physician groups fighting this ‘healthcare transformation’ battle in real time. Stringing the anecdotes together is not a chart, but is insightful…
- Several surgical practices have come together, 100 providers in all, to become a strong player in a market dominated by three powerful health systems. Now they are in a partnership with a payer to move cases from the hospital outpatient departments to ambulatory surgical centers. The physicians will get a financial kicker for doing so and the payer will save boatloads. Other payers are also interested.
- A primary care-centric IPA that was formed years ago to take capitation risk has now merged several practices from within the IPA into a 30-provider group to create an alternative for physicians who want to be part of larger practice, but want that practice to be owned and run by physicians instead of the hospital. Payers are supportive because, in that market, most primaries are employed by a hospital, immediately raising the cost of care due to the site of service differential.
- An investor-backed venture is delivering mobile homecare visits as an alternative to expensive trips to the emergency room. They are growing like crazy and have contracts with almost all the major carriers in their markets.
You know that I love numbers, loves charts and thinks a good graph of data is just further evidence of a Divine Creator. I consume most of the healthcare data I can find, especially things that relate to independent physician practices.
But anecdotes are data as well, and these three seemingly random conversations this week point to a truth as valid as a trend line: There are many spunky, thriving independent physician practices who are engaging with the market, often those responsible for paying the bills, to find better answers. They may not be coveted speakers at the big, big conference or policy wonks testifying before Congress. They are just out, on the ground, actually helping solve the problem.