Marin General finalizes acquisition of sixth practice

GREENBRAE -- Marin General Hospital has finalized the addition of a sixth medical practice to an expanding network of clinics it will now operate, a development seen as pivotal for the hospital as it looks for ways to attract and retain physicians amidst an increasingly consolidating, reform-driven health care landscape.

Since returning to the publicly controlled Marin Healthcare District in 2010, Marin General has acquired Cardiovascular Associates of Marin and San Francisco Medical Group, the San Rafael Medical Center, North Marin Internal Medicine, West Marin Medical Center, Marin Medical Group, and the Soluna Sausalito Medical Clinic. A total of 29 physicians are now associated with Marin General via the new clinics.

Individually, the practices are small, but taken together it represents a significant infusion of physicians associated with Marin General. And it could better enable the hospital and its physicians to form accountable care organizations, known as ACOs, that are now permitted under the Affordable Care Act and overseen by the Centers for Medicare & Medicaid Services, said Jon Friedenberg, the district's chief fund and business development officer.

"We will be in a better position to deal with those changes if we are aligned with our local physicians than we would be if we were not," Mr. Friedenberg said. "If all the consultants are correct and we end up with bundled payments and ACOs, we'll be in a much better place." 

Accountable care organizations are viewed by many as a more cost-effective way for providing a range of specialty and primary care by integrating once-disparate factions of health care, including physicians, hospitals, HMOs and insurance carriers.

Under the 1206(b) provision of the state health and safety code, health care districts are permitted to acquire medical group assets and contract with physicians. The Marin district is taking full advantage.

The recent clinic acquisitions are in addition to other efforts, such as the formation of the Prima Medical Foundation with the Marin-Sonoma IPA and strategic alliances with other hospitals in the North Bay, all of which will help the involved parties adapt to a rapidly evolving business environment, Mr. Friedenberg said.

Even without the impacts of health care reform, health care district officials said the alignments made sense and will help provide both efficient and integrated care.

"There is tremendous benefit to the greater Marin community in integrating these premier practices with Marin Healthcare District and Marin General Hospital," said Lee Domanico, CEO of of the district. "Residents can be assured that their primary and specialty health care needs are met close to home through our newly broadened network of physicians."

The group of cardiologists was the biggest of the recent acquisitions, with 14 physicians. A cost figure for acquiring the six practices was not immediately available, but  Mr. Friedenberg said each is expected be a significant revenue source for the hospital.  Smaller practices, likewise, stand to benefit from the integration, as they would not have the ability to form ACOs or negotiate higher reimbursement rates with insurance carriers. 

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