July 13, 2020

Area health professionals teamup > Managed care concerns lead to Sunbury practice

BANGOR — Sunbury Primary Care is a new development in the local medical community, but if it does what it’s supposed to, people will hardly notice the change.

The consolidation of eight medical practices into one group practice with eight locations in several communities, Sunbury was designed in part as a way of protecting physicians in rural places in the era of managed care. Groups of doctors have more clout than individuals with insurance companies, Sunbury President Dr. Larry Smith said.

“We all have strong roots in our communities, and we want to stay and serve patients for the foreseeable future,” he said. “To do that, we decided to work closely together. We decided there’s safety in numbers.”

Sunbury, made up of 27 doctors, physician assistants and nurse practitioners, is an evolution of the NorthEast Medical Service Organization, a group of family practitioners with ties to St. Joseph Hospital formed in the early 1990s.

NorthEast MSO participants pooled their billing and some other administrative services, but remained independent practices. Sunbury takes the group — with some difference in membership — a step further to full consolidation.

Group practices in Bangor, Brewer, Carmel, East Corinth, Hampden and Winterport will be linked on one computer system with one laboratory and one central administrative office to deal with insurance companies. Sunbury doctors will stay on staff at both Bangor hospitals, but will continue to use St. Joseph as their primary site for inpatient care.

Leaders expect Sunbury’s membership to grow. “We think more doctors in the region will want to work with a larger group,” Dr. Smith said.

“Solo practitioners, hanging out a shingle, aren’t in existence any more. That was a wonderful time, but it’s not 1950,” he said. “Under the old model, we were out there scraping to survive. Now we can move from survival to thrive mode.”

As a group, the doctors will have more say about the insurance programs offered to their patients, he said. For example, if Sunbury doctors demanded together that Blue Cross or NYLCare provide new members with a free introductory physical, the companies would be more likely to consider it.

The Sunbury group will also have treatment guidelines and a patient satisfaction survey process at every office, elements that give insurers peace of mind about the consistency of their providers.

Quality improvements are expected, both in medical care and insurance coverage, Smith said.

“Before, between putting out fires at both hospitals and struggling to keep up with insurance negotiations, there wasn’t time to step back and ask, `Are all my patients immunized?’ We should be able to be more proactive,” he said.

Pamela Bruce, the new group’s director, explained that Sunbury was the original name proposed for the city of Bangor, when Maine was still part of Massachusetts. The Rev. Seth Noble rejected the name when he traveled south in 1791 to incorporate the place he decided to call Bangor.

Sunbury Primary Care includes Brewer Family Medicine, with doctors Ken and Julianne Simone; Dr. Susan Stevens at Carmel Health Center; Corinth Family Medicine Drs. Tom Hayward and Marie Albert; and Drs. Ann Hanlon, Martha St. Onge and David Tolstrup at Hampden Family Medicine.

Other members are Dr. Gary Ross of Brewer; Dr. Barbara Vereault of Sunbury Family Medicine in Bangor; Winterport Family Medicine, with Dr. Smith and Drs. David Rocker, Joseph Sardina and Mary Eyerer; and HealthWORKS, St. Joseph Healthcare’s occupational medicine program run by Dr. Craig Curtis.

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