When Dr. Michael J. Edbauer finished his residency and started work as an attending pediatrician in the ambulatory clinic at Women & Children’s Hospital of Buffalo in the early 1990s, he was asked to join a pilot program that explored how to pay doctors monthly, instead of when they saw their patients.
The goal, Edbauer said, was to think about how to link payments to doctors’ efforts to keep their patients healthy, instead of paying them when their patients got ill. The doctor running the program needed someone young to whom he could hand off some of the work.
“That was my first introduction to the administrative side of things,” he said.
Since then, Edbauer has continued to practice as a pediatrician even as he has advanced through leadership positions in the local health care industry.
In 2006, he joined Catholic Medical Partners, which represents the more than 1,000 doctors and specialists affiliated with the Catholic Health System. Edbauer served as chief medical officer of the organization until Jan. 1, when he replaced Dennis R. Horrigan as its president and CEO.
Horrigan and Edbauer are credited with helping the group’s physicians and Catholic Health respond to the ongoing transformation of how health care is delivered. Catholic Medical Partners has supported its members’ clinical practices, led to the adoption of electronic health records and participated in an accountable care organization, known as an ACO, that lowered spending on care and improved outcomes for Medicare patients.
Edbauer also is chief clinical officer at Catholic Health. The Amherst native and alumnus of the University at Buffalo, where he studied biochemistry, graduated from the New York College of Osteopathic Medicine and later earned an MBA from Canisius College.
Q: What is Catholic Medical Partners?
A: We’re an IPA, independent practice association. It is an organization of independent physicians within the community. We have over 1,000 physicians. We have come together to work on projects, infrastructure, to improve the delivery of care, both in the form of quality outcomes, reduced utilization, and really improving the patient experience.
Q: You’re the first physician to run Catholic Medical Partners. What perspective does that give you?
A: I do think it’s a different perspective. Physicians, through our interaction with patients in the clinical setting, we do have a different appreciation for what’s involved. Not only the direct care of patients, but understanding the greater components that influence the health care of individuals. What’s now being coined the social determinants of health.
Q: What does that mean?
A: I probably wouldn’t have used that term 20 years ago. I don’t know if it was being utilized. But I think as practicing physicians you appreciate the fact that the social circumstances surrounding your patients influenced their level of health and influenced their ability to take advantage of the various options that you were offering them in developing a treatment plan. So really recognizing the value of education, housing, family stability, economics, all those things really affect the health care. And it’s important to be aware of all of those things to put together a plan that’s effective to take care of your patients.
Q: What benefits does the Catholic Health hospital system derive from its ties to Catholic Medical Partners?
A: Well I would say it’s kind of a symbiotic relationship. By having a group of physicians who are very closely aligned with a hospital organization – in our case it even goes beyond the hospital to having home care services, long term care services, diagnostic services, etc. – it allows you to be able to work across the continuum to impact all the components of care. So this idea of an integrated delivery system.
Q: How does that work?
A: So for an example, early on, we recognized when a patient was admitted to the hospital, from the physician organization point of view, we wanted to be able to influence the quality outcomes that were occurring in the hospital as well. So, working with Catholic Health, we’re able to have our physicians and the hospital administrators work very closely to identify opportunities, whether it was reducing post-operative infection rates, perhaps it was around service issues, by decreasing wait times in emergency rooms, etc. So you’re really bringing all the parties together, who now have an aligned interest in saying, how do we make these improved outcomes? And in the IPA model, it’s not only philosophically aligned, you’re actually financially aligned, where you’re at risk as well. So if you don’t perform well, both the doctors and the hospitals have risk. And if you do well, there’s the opportunity for sharing in some of those gains.
Q: Medicare is beginning to grade ACO physician practices on their results from patient satisfaction surveys. What are Catholic Medical Partners members doing to improve the experience of their patients?
A: We’ve actually helped our doctors with understanding processes to improve the scheduling of patients, so that there’s less wait time on the phone, less wait time in the office, those type of things. And as recently as this week, we’ve started to roll out, in conjunction with our broader network of partners, a cultural diversity training, especially as we see more and more people in Western New York where we have greater number of immigrants, etc. Really understanding the needs of the patients and how to do a better job of listening and communicating to meet those needs.
Q: Now that we have electronic health records, what can we do to put them to good use?
A: For example, pulling the data from the electronic health record, it’s easy to identify if you’re in need of a test, a screening test, that perhaps I missed when you were in last time. It’ll help me and my staff recognize that you’re due for a follow-up. And maybe reminders that are sent to you automatically giving you new information about your care, whether it’s a reminder around healthy life habits, or perhaps if you have a chronic disease, some tips to help you with the management of that.
Q: What can be done to encourage more medical students to go into primary care?
A: Being a primary care doctor is very challenging given all the aspects of care that you’re responsible for with a patient. At the same time it can be incredibly rewarding with the relationships you develop with patients and families over the course of a career. What I think the opportunity is for an organization such as CMP is to help provide the infrastructure support, whether it’s in the form of electronic health records, new software, helping with the regulatory things, providing the expertise and support so the practices can really focus on continuing to provide medical care, as opposed to having to worry about all those ancillary types of work that are associated with it. So by improving the infrastructure of both technology as well as human resources I think we’re able to allow our primary care physicians to experience a quality of life that is better than perhaps what’s being experienced by the average primary care physician across the country. Having said that, I think we have to do more.