Doctors' collective aims for better care

All three of the East End's hospitals and nearly a third of its doctors are forming a collective Physician Hospital Organization that can negotiate with insurance companies to track patient care, improve the reimbursement process and seek changes in treatment practices to eliminate unnecessary work.

Peconic Bay Medical Center in Riverhead, Eastern Long Island Hospital in Greenport and Southampton Hospital make up the partnership along with 63 of the 200 physicians practicing on the East End.

Dr. Scott Sheren, managing partner of East End Eye Associates and co-chairman of the new PHO, said the organization would develop a computer-based set of standards showing which treatments were the most effective for patients and would then discourage unnecessary procedures. The group also plans to negotiate with insurance companies to set better insurance rates than those offered individual doctors. Sheren said he hopes those two steps will lower the overall cost of patient care.

The East End Physician Hospital Organization, which was announced last month, is modeled after a similar venture in Boston, and several similar organizations in New York City.

Each of the physicians in the organization paid $2,500 to join. Peconic Bay Medical Center matched that money through a $500,000 federal grant, according to Bobby Goodale, vice chairman of the East End Health Alliance, a separate group formed by the three hospitals to, among other things, share services.

While the new concepts will likely be phased in over several years, Goodale said the first target group -- diabetes patients -- could be evaluated in six months. He said there were thousands of people with diabetes on the East End.

In theory, the new system will allow physicians to study their patients as a group, looking at the kind of care they have been getting and what the results have been. The data would then be compared with national standards.

Each patient and his or her physician would still have to determine the best course of treatment for that person, Sheren said.

Technology has improved medical care, but complicated patients' ability to understand it, Goodale said, adding that years ago, the most sophisticated piece of equipment in a hospital was the elevator.

"Now things are really sophisticated . . . patients have difficulty assessing what the quality of treatment is," he said. "This is really about integrating health care on the East End . . . each doctor can look at the [treatment] measures over time . . . look across the whole population."

Goodale said that the complexity and cost of the health care system, and new federal laws, mean changes are coming to the system and the PHO would enable East End doctors and hospitals to better address those changes as they take place.

East End Physician Hospital Organization

Members: Peconic Bay Medical Center in Riverhead, Eastern Long Island Hospital in Greenport, Southampton Hospital and 63 East End physicians

Established: Last month

Goals: Sharing patient histories to better treat similar conditions in the future, negotiating with insurance companies to improve the reimbursement process, reducing unnecessary use of time and resources