How Private Practices in Richmond Are Overcoming Big Challenges

In our “Physician Voices” podcast series, doctors share their unique stories, expert perspectives, and helpful insights. In this episode, we welcome Keith Berkle, MD, MBA, a board-certified OB-GYN at Virginia Women’s Center, which has five locations in the Richmond area. Our conversation examines challenges private practices in Richmond face, such as payer contracting, consolidation, and competition with local health systems.

This excerpt of our conversation is edited for length and clarity. You can listen to the full episode below and find us on your preferred platform.

Q: Before you joined one of the leading private practices in Richmond, you completed your undergraduate, med school, internship, and residency in the area. Given your deep knowledge of the region’s healthcare landscape, what would you say are the main issues local private practices face?

In our community, we have two very large health systems, the big academic center, and lots of smaller private practices. My practice, frankly, isn’t particularly small, but (with a few, highly specialized exceptions) most of the other private practices in Richmond are.

The biggest threat I see is acquisition by those systems. I don’t think that’s always the wrong choice for practices to make, but there are significant tradeoffs in terms of autonomy and innovation.

In private practice, we’re able to focus on what we believe is really important to drive equity and savings to make our patients’ healthcare dollars go further. We can holistically develop our business plan, model, schedules, and compensation structure so that we have happy doctors and well-cared-for patients. And I’m not sure that my colleagues in the health systems have that degree of control over their day-to-day.

Q: Privia’s contracting, tech, collaborative community of doctors, and preservation of practice ownership led Virginia Women’s Center to partner with Privia in 2018. Since then, what results — both immediate wins and long-term success — have you seen?

One of the first and most obvious improvements we saw was to our payer contracts. It was significant and immediate. Privia executed a pro forma ahead of time and said, “We think we can do this,” and boy, did they. So right away we saw an increase in revenue just based on the that.

Q: In addition to better reimbursements, you’re also able to offload contract negotiations to our specialized teams. What did your contracting processes look like before joining Privia versus now?

Before we were aligned with Privia, we had lawyers working on our behalf (and whom we’re paying by the hour) who would sit down with Anthem and have these discussions. And we weren’t incredibly successful. It was a frustrating, hair-pulling experience.

Now, Privia handles contract negotiations for us. Their actuaries and analysts are able to come to the table with the payers on behalf of the 1,500 providers in our Mid-Atlantic market and not only suggest changes to contracts but also provide real data about why those changes should be made.

Discover how Privia helped three private practices in Richmond improve RCM, grow their practice, and excel in value-based care.

Our electronic medical record, athenahealth, is so incredibly flexible. There’s a significant amount of depth to the data and metadata that Privia’s actuarial team can really pull out all of the truth about the quality of medicine we’re providing. Then they can show that to the payers. It’s made contract negotiations, number one, something I don’t have to worry about at my practice and, number two, highly successful on behalf of my practice.

Q: Declining reimbursements also make recruiting providers more difficult. Have you seen improvements there as well?

Since partnering with Privia, we’ve seen 14 percent growth in our provider cadre. That’s spectacular. We hadn’t seen that much growth in the whole time I was at Virginia Women’s Center before joining Privia. We’re no longer having to hang our heads when we make an offer to doctors; we can offer them a competitive local salary right out of the gate.

Keith Berkle, MD, MBA, is the Chair of Privia Women’s Health and President of Virginia Women’s Center. Outside the office, Dr. Berkle is a member of the Richmond Academy of Medicine’s Access Now program and takes yearly mission trips to Guatemala to provide free gynecologic surgeries to underserved populations.

Learn more about Privia Women’s Health and how to become part of Privia Medical Group — Mid-Atlantic.