Clinic partnership hopes to invoke a bit of Marcus Welby, M.D.

The large specialty group Twin Cities Orthopedics and three other private practices have planned a partnership to create Infinite Health Collaborative, a group that is trying to cast itself as different from much of the consolidation activity in health care. Health insurers and private-equity groups have been buying into the clinic business; hospitals continue to buy medical groups to develop larger health care systems. Dr. Owen O'Neill, an orthopedic surgeon who is one of the owners of Infinite Health Collaborative, said the new group is trying to preserve older ideals of medicine where physicians and patients are independent of larger groups when making decisions. He invoked the example of "Marcus Welby, M.D.," the TV show from the 1970s that showcased a doctor's warm bedside manner.

Q: Why launch Infinite Health Collaborative now?

A: We're focused on patient choice as well as autonomy for physicians. We believe that independent practices and independent physicians are really at the center of patient care. And ultimately it's in partnership with patients that we can help drive value in health care.

Q: In addition to Twin Cities Orthopedics (TCO), the collaboration is expected to include two primary-care groups and an obstetrics-gynecology practice. How will this work?

A: This is an integration model between practices. The practices are integrating into a larger entity. Any practice that was part of their own independent practice — were owners of their own independent practice — they'll continue to be owners in the new business. So, it's more of an integration model in which physicians continue to be partners and owners within the new practice.

Q: Why not sell to an outside group?

A: Where physicians are acquired by large health care systems or private equity or maybe by insurers, what happens is the physicians lose that autonomy.

Q: Will primary-care providers in Infinite Health Collaborative be encouraged or compelled to send patients to the specialists who are part of the group?

A: Absolutely not. Anybody within the collaborative, the ultimate goal is to treat, take care of, the patient in the best way possible. As independent docs, you could still absolutely refer a patient to a [doctor at a] health system or a physician who is at a different facility or a different arrangement.

Q: How many physicians do you expect to be part of the collaborative?

A: There will be more than 160 independent physicians once this is launched, and I think this is just going to continue.

Q: As you are putting this together, are you getting any private-equity funding?

A: No, there's no private equity. We don't think private equity really adds value to the model. Because, again, it's taking money out of a system designed for patient care.

Q: When I've written about health systems acquiring clinics, doctors describe things like electronic health records and access to capital — things where getting bigger, or selling to a larger group, helps with the business side of running a practice. Are there elements of that with this arrangement?

A: There's no question. ... It's very difficult for smaller groups, particularly if they're independent, to manage, I would say, the necessary government regulations in terms of electronic medical records, IT, those types of things. As a larger group, you do get that economy of scale that probably wasn't necessary in the Marcus Welby days.

Q: As you are putting this together, are you thinking about health insurance contracts that put health care providers at financial risk for cost and quality?

A: It is actually part of the idea to have what we call value-based care. Value-based care means creating better value for the patient — higher quality but at less cost. Twin Cities Orthopedics has been a leader nationally in something called bundles, [where] we have taken risk in orthopedic procedures. As we've taken the risk, we've actually lowered the cost of joint replacements by 30% for each individual procedure, really over the last six years, which equates to $60 million of savings.

Q: With these contracts, health insurers are showing more interest in owning clinics. Are any insurers putting money in this venture?

A: No, we don't have an insurance company that's put money into it, nor are we interested in that. We don't find a lot of value in having an insurer, frankly, owning physicians.

Q: You mentioned Marcus Welby. This is a new entity you are creating, but are you trying to preserve some old values with this?

A: Yes. Marc Welby — it may be many of your readers don't know who Marcus Welby was. It sort of dates me, I guess. But yes, we want the core value [which], again, continues to be the physician-patient relationship. It's really a shared decisionmaking process. We want to get back to that or stay within that situation where we're able to take care of our patents the best way we can, unencumbered by someone telling you … how you have to do it.