Dear Colleagues:

         CJHIEP has worked diligently to be designated a 501(c)3 (509(a)2) not for profit public charity organization whose focus is for the public good rather than that of a locally funded and limited focus group.  We have established our IRS standing, submitted our budget, established our bank account and received our merchant standing to be able to process credit card payments, placing us further along than many of the organizations whose corporate structure and status are not yet beyond the proposal stage.

     One thing has become obvious; the hospitals of our region continue to vie for our sole dedication and our patient population referrals.  As medicine continues to evolve, it is becoming imperative that we start to work towards our common good rather than our individual benefit.  The established systems need to hear a common and practical voice for us to survive healthcare change.

The EMR vendors continue to try to broker separate deals with each group or individual.  We have been countering the alterations of our negotiations as we find out about them.  Now that we have set up our systems, it is the time for you to officially join CJHIEP and submit the nonrefundable tax deductible fee of $100 per year for membership which you can do on line at CJHIEP.org with a credit card. 

     We will forward the negotiated terms with ADS, MDTablet and Greenway at your request and advocate on your behalf should they not honor the terms.  Full compliance with meaningful use was guaranteed by all vendors.  Interconnection between the vendors was agreed to without further fees.  Training programs with organized training sessions were to be established on a preferred hourly rate. 

     Each of the local Hospitals have started to reach out to establish physician alignment in their own ways attempting to "lock in" physician referrals according to old models merely relabeled for a new effort.  As we go forward, we at CJHIEP encourage the maintenance of our own individual practice identities but also recognize the simple fact that we are much stronger when we speak in unison as well.  We, in our various roles as leaders in the local hospitals, have found it will be absolutely imperative for the survival of the private practice of medicine, to speak as a unified front as accountable care organizations (ACO, the latest name put forth to describe an integrated delivery system) are established. 

     The focus of an ACO is the initial gain sharing of funds produced by efficiencies established.  This means the supplementation of fee for service for quality of care, splitting of any generated profit between the participants.  (As examples: 1. hospital or office $50 visit + extra money to the physician, 2. hospital daily rate split between insurance company and ACO).   Most of the money will be saved on shortened and more efficient lengths of stay.  We, as private physicians, need to be included in this distribution of savings; this includes ALL members of the ACO, even those not admitting to the hospital if the physicians are participating as one of the entities included in the makeup of the ACO. 

     CJHIEP has found that much of this negotiating has been going on around us and, the private physicians in the region need to be represented.  For this reason, we propose that CJHIEP provide that framework for negotiation of the terms and the distribution of these funds to the physicians of the area.  Our bylaws will need to be rewritten to split the organization into 2 arms, one for representation of the private physicians, possibly with involvement of the local medical society to incorporate our divergent knowledge and the other, the EMR/HIE arm continuing to work on establishment of locally interconnected health information.  No individual will be forced to participate in any contract they do not believe in, however, it will allow a commonality in our voice to be heard negotiating with the local hospitals and systems.  Just recently, as an illustration, RWJUH had proposed a joint venture ACO as a 2 -pronged entity with RWJUH and RWJMS but now, changed it to a 3-pronged model to allow CJHIEP and therefore, the private physicians to be included. SPUH as it attempts to maneuver with physicians has been using Relay Health, a subsidiary of McKesson, to interact between physician practices and hospital systems.  Relay has demanded as much as $5000 for transfer of demographics from an Allscripts eRx platform for a private physician group to be included.

     As these processes proceed around us, please join us officially with your membership dues of $100 per year to give us the voice you need to represent you in negotiations on a more corporate level.  As stated above, you will not be signed to any contracts by CJHIEP without your agreement, but make your voice count! 

     Each hospital and system has a different target physician population and the presence of your voice can change the planned implementations around you.  If you are interested in becoming more involved, the doors are open.  Search this website for more information.

     Medicine is changing in an exponential rate.  Please remain engaged.