By Jonathan LaMantia
As appeared in: Crain's Health Pulse
SEPTEMBER 18, 2018—As CEO of Summit Medical Group, Dr. Jeffrey Le Benger has overseen the growth of the practice to more than 800 providers in central and northern New Jersey. He joined Summit in 1989 and became chairman and CEO in 2000. His role expanded when Summit Health Management was created in 2014 to offer administrative services to group practices. In January it started working with providers in Phoenix, Ariz., and Bend, Ore. In October Summit is planning the grand opening of the 130,000-square-foot Summit Medical MD Anderson Cancer Center in Florham Park, where it has already begun offering interventional radiology services. Le Benger spoke to Crain's Jonathan LaMantia.
What has been your growth strategy?
Right now we are growing Summit Medical Group in concentric rings in northern New Jersey. We bring on about 150 physicians per year in the state. We grow an average of about 20% in revenue per year in New Jersey alone. In other areas of the country, we look at books from investment-banking firms or we find other groups that might want to look at a physician-owned model, which we are.
Have you explored expanding in New York?
We looked at groups in New York. You're competing against large hospital systems that [can] acquire Crystal Run. You're looking at competing against Optum, which is owned by UnitedHealthcare, and is acquiring practices. It's a very different model. We don't use a model of monetization. We look at it as shares within the management company. The share price goes up, there's a dividend; it's almost a deferred compensation. A lot of doctors want monetization.
Are you financed by private equity?
We have no private-equity backing. Doctors capitalized on two offerings in the group with cash, and we have debt that we could apply for. At this time, we don't need a capital partner. In the near future, as we continue to grow and have more competition in the marketplace, we might need a capital partner.
How have you handled the move toward value-based payments?
We have probably the most progressive risk-based, value-based contracts in the state with Horizon Blue Cross Blue Shield. We have over 528,000 unique patients.
How does what you're doing compare to other providers?
What I see in New York state and New Jersey is they're all based on a fee-for-service platform, and then by reporting quality metrics, they get per-member per-month [payments] for that. They don't have that much downside risk with their contracts. About 65% of our contracts are fully at risk.
How does that work?
We have 100,000 attributed lives with major payers. We look at their total cost of care, and we compare it to the marketplace. If we don't beat that total cost of care, we get a downside penalty. If we beat that total cost of care, we get some arbitrage of that health care dollar. Our model is that we have high-acuity urgent care. We use our urgent-care center, where we can do infusions, where we can get specialists to see them, where we can keep them for hours to be certain we can miss an admission. You want to decrease the length of stay and admission rate.
What kind of relationships do you have with local health systems, such as Atlantic, Hackensack Meridian and RWJBarnabas?
We're Switzerland. We have good relationships with all the systems. We have a joint venture with one of the systems on an ambulatory surgery center. We're looking with one system to do something in the post-acute-care setting. We don't own a hospital and don't want to. We move everything toward the outpatient setting.