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Thursday, Mar 28, 2024

Bill Gil

At a time of enormous change and uncertainty for the health care industry, the San Fernando Valley region is home to many who are embracing the challenges boldly with new ideas and fresh vision. The 10 innovators profiled in the following pages are emblematic of the important work performed by health care workers every day. They are working to improve care and lower costs — and answer the urgent need for a better health care system. Electronic medical records are just now finding their way into many doctors’ offices. Bill Gil made sure that the 180,000 patients of Facey Medical Group had them almost 10 years ago. Now Facey is making strides in health care reform. A $1 million grant from Blue Shield of California will help Facey study and launch an accountable care organization, one model of health care reform that has the promise of reducing costs and delivering superior and coordinated care to patients. There is no guarantee that doctors can deliver on the promise of ACOs. The challenges are many, and if doctors fail to deliver savings, it is they — along with the insurance companies — who are on the hook for the cost. Gil’s up for the challenge. As the businessman behind the doctors who care for two-thirds of the residents of the Santa Clarita Valley, Gil has been at the vanguard of health care reform for 30 years. He has held senior executive positions at Pacific Physician Services, the first publicly-traded physician practice management group; he also has served as CEO of an HMO, and as CEO of a management services organization made up of 16 hospitals in Florida. In the Santa Clarita Valley, Gil made his name helping Facey manage the delivery of care to 180,000 patients as President and CEO of the Facey Medical Foundation. With two-thirds of Facey’s patients enrolled in an HMO, Gil has had to make sure that care was not only effective, but efficient. That means keeping patients healthy in the long term. It’s about making sure patients get their colonoscopies, mammograms and pap screens in a timely manner. And it means making sure all children are properly vaccinated and all elderly patients receive a flu shot. It may seem counterintuitive that more tests will lead to declining costs, but if Facey can avoid a diabetic from needing an amputation, or keep an elderly person out of the ER with a flu shot, they may save money in the long run. To coordinate care, Gil helped implement an electronic medical record at Facey long before anyone else. “We pulled the last medical chart here on Oct. 1, 2002,” said Gil. Gil also implemented a decision support system for Facey’s doctors. Facey pays $60,000 a year for Milliman Care Guidelines, a software system that helps doctors choose evidence-based treatment. “It does not mean the physician is not allowed to pursue his own approach,” Gil said, “but that resource is available to him to make sure the patient gets the right care.” Such innovation puts Facey in the ideal position to test the accountable care model with Blue Shield. As the partners launch the concept, they will also be measuring how well such a partnership between doctors and insurance plans can work. All eyes will be on Facey and other provider groups like it to see how well the ACO model will work. Gil has seen it before. As chief operating officer for UniMed Management Co., he saw firsthand the potential — and pitfall — of doctors working with hospitals and insurance plans. The first iteration of integration was not successful and UniMed fell apart. Doctors went their own way and the hospitals were sold. The time was not yet ripe, Gil explained. This time, as he scans the horizon, once again looking for potential hospital and insurance company partners for Facey, he thinks the time is right. “Twenty years ago, the idea was that if we integrated the medical groups and hospitals, we could build mega-groups that could command some market power and be able to effectively drive care in the right direction. “It made a lot of sense, but the timing was not right because the mandate was not there. There was no political mandate for health care reform then. But now we have the mandate and we know that the fee for service model is something we just can’t afford. The time is right now.”

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