Strength in numbers

View This Article in BOSS Magazine

South Bend Clinic is helping to drive healthcare modernization in the upper Midwest through the creation of an integrated network of independent physicians.

In 1916, Indiana surgeon Dr. Walter Baker toured the world’s first nonprofit, multispecialty group practice. He was so taken by his visit to the then-27-year-old Mayo Clinic that he returned to South Bend and, together with other doctors in the area, assembled a group practice of his own based on the principles of physician-led, patient-centric care that he’d witnessed.

With 10+ campuses and roughly 180 providers serving Northwest Indiana and Michigan, today’s South Bend Clinic continues its founders’ mission. Now, the clinic is partnering with healthcare systems and physician groups in the region to create a clinically integrated network designed to improve the provision of quality care while controlling costs and preserving the independence of physicians in the communities they serve.

The network, Integrative Care Partners, is a combined effort founded by The South Bend Clinic, Michiana Hematology and Oncology, Family Medicine of South Bend, and Allied Physicians of Michiana. Several new members have since been added as well. In 2020, South Bend, Allied, and South Bend Orthopedics purchased Unity Medical and Surgical Hospital, which has become a physician-led organization under its new leadership. Later in the year, Allied merged with the South Bend Clinic.

Kelly Macken-Marble, CEO of the South Bend Clinic and Unity Hospital, oversees the rapidly growing coalition. “I saw an opportunity to better align the independent physician groups across our region just like we’ve seen happening in other parts of the country,” she told BOSS. “There were physician groups in Mishawaka and in the Northwest Indiana area that want to stay independent, and I believed there is significant value to the community in our organizations staying independent. Initially, my focus has been getting all the groups aligned with the belief that it keeps the cost of care down … and it also preserves choice in communities.”

The 30-year healthcare industry vet set out to unify competitive groups to become stronger together within the network. “If you think about it from the context of what's happening in most markets with health systems hiring independent physicians very rapidly, oftentimes plucking physicians from our group, and their ability to hire physicians at substantially higher salaries, it’s becoming very hard to compete with that,” she explained.

Shifting from the competitive mindset to one of partnering with other like-minded independent groups has proved challenging for some. “It took time for some physicians to really understand the value of our coming together, but in a short amount of time we've come a long way. We still have certain pockets where we are competing, but overall we are more aligned. We have a similar vision and we're really focused on that alignment, so it's gone well,” she said. In addition to offering opportunities for buying malpractice insurance, other forms of group purchasing, and technology sharing, the network shares its data to show cost, utilization and other information.

“Sharing data is a requirement of a clinically integrated network so we can show employers or insurance companies where we’re able to provide high-quality, lower cost of care options, which is great because employers are really looking for that today,” she said. “Through this network we're able to share resources, we can contract together as a larger group, and we have more leverage with some of our contracting opportunities while we still maintain independent companies outside of the network.”

Ultimately, the resource sharing will lead to lower overhead costs, and considering that Indiana is one of the most expensive states in the country in terms of healthcare costs, that’s a very attractive advantage.

“The more physicians we have in the network, the more leverage we have together collectively and in contracting,” Macken-Marble said. “Smaller independent physician groups might not get the same rates with an insurance company as when you're with a group purchasing company.”

The network also gives participating groups the ability to take advantage of size. “As we contract with employers to provide direct to provider relationships, ultimately our organization grows to be able to shift the volume of work and the benefit of that volume as well,” she said.

South Bend Clinic is currently partnering with NextGen Healthcare for its electronic health records system. “Over the course of my career I’ve had the opportunity to work with a lot of EMR vendors, and what is really nice about NextGen Healthcare is their partnership. Most do a good job but they are big companies that don't have the ability to focus on individual organizational needs. NextGen Healthcare really has done that,” she said. “It's been a great relationship. They're working really hard to accommodate our growth and our needs as we continue to get bigger and more sophisticated with more specialties and a more complex organization.”

In addition to her contributions to Integrative Health Partners, Macken-Marble's expertise in lean leadership is helping to propel the South Bend Clinic into the next generation of healthcare.

“We've done a lot of work to implement strategy deployment; which takes your strategic plan and creates leading indicators, clear goals and data to drive improvement,” she said. “It's been a transition for the organization to think differently about how we execute on a strategic plan to look at more real-time data to drive improvement, but it's been incredibly successful. For me, it's about empowering the full leadership team and our teams on the front lines that do the work daily, providing clinical care and making improvements.”

“I'm incredibly honored and proud to be able to work with this group of physicians, both at the South Bend Clinic and with our partners in the network, and at Unity Physicians Hospital,” she continued. “This group is incredibly passionate about providing value to the communities that we serve.  The physicians in the network and the South Bend Clinic are just great to work with and very well-respected physicians. That’s our baseline. In addition to that, they feel really passionately about providing that great care but also making sure that we’re providing lower cost of care options in the community.”