Physician Direct ACO | Phone: 248-762-4996 | Email: info@physiciandirect.org

Contact

Physician Direct ACO
2360 Orchard Lake Rd. Ste 105
Sylvan Lake, MI 48320
Phone: 248-762-4996
Fax: 248-682-6044
Email: info@physiciandirect.org

ACO Participants

For a Complete List of Physician Direct ACO Physician Participants: Click Here

For a quick list of Physician Direct ACO Primary Care Physicians: Click Here

Mission

Physician Direct ACO healthcare network will be a market leader in the delivery of efficient cost effective health coverage.  Physician Direct ACO healthcare network will reduce the costs of health coverage by putting more dollars into well care to reduce sick care and by putting fewer into administrative overhead.  Physician Direct ACO healthcare network will accomplish this goal by using state-of-the-art technology, carefully selecting care providers, lowest cost outsourced administrative services possible and adopting medical protocols that will be closely monitored and regularly reported.  Physician Direct ACO healthcare network is premised on ownership and control by physicians.

Organization

The primary business location of Physician Direct ACO healthcare network is 2360 Orchard Lake Road, Suite 105, Sylvan Lake, Michigan 48320.  The legal name of the ACO is Physician Direct ACO LLC.  This initial form of organization was chosen to insure maximum flexibility during the feasibility and initial capitalization stages of the company.  Physician Direct ACO healthcare network is organized by Oakland Physician Network Services (OPNS).  OPNS also has a wholly owned subsidiary that holds a Third Party Administrator license in the State of Michigan.  Additionally Physician Direct ACO will collaborate with AssureCare (a Third Party Administrator) for claims payment as needed and with US Underwriting Services, Inc. (a Managing General Underwriter for stop loss insurance as determined to be prudent) for appropriate risk coverage.

History of Physician Direct Accountable Care Organization (PDACO)

OPNS is a leading physician organization in Southeast Michigan that was established in 1993. The original organization, OPN, LLC, was the physician partner in a joint venture with St. Joseph Mercy Oakland Hospital (SJMO) one of the Trinity System hospitals in Oakland County Michigan. The joint venture, Physician Hospital Organization (PHO), was named MOPN.

In 2000, OPN, LLC became a separated legal entity from the hospital joint venture when it established the independent physician association (IPA) known as OPNS, Inc.

In 2005, OPNS established a wholly owned subsidiary known as OPNS Enterprises, LLC (OPNS-E) to pursue additional investment opportunities for direct to employee and direct to patient services. In 2011,     OPNS-E established the DBA Physician Direct Accountable Care Organization and PDACO, to be the vehicle for the wholly owned subsidiary for the specific purpose of establishing an ACO.  In 2014, CMS approved OPNS-E dba Physician Direct Accountable Care Organization as an ACO under the Medicare Shared Savings Program (MSSP).  The Organization’s legal name was later changed to Physician Direct Accountable Care Organization LLC to reflect the Organization’s sole line of business and commitment to serving as an ACO, and consolidate branding and public perception. 

In 2015, SJMO acquired a 25% minority ownership interest in Physician Direct ACO, bringing the experience and resources of the one of the country’s largest and most highly regarded non-profit health systems, including prior experience with other ACOs recognized by the MSSP nationwide.  SJMO had been, and continues to be the primary hospital for the ACO, as well as the employer of 37 of ACO’s 140 physicians.  SJMO’s participation broadened Physician Direct ACO’s ability to provide cost savings, both by drawing on the experiences and best practices developed by other ACOs, and by providing Physician Direct ACO’s primary hospital with a vested interest in the success of the Organization, including achievement of cost savings. 

OPNS has extensive managed care experience and has developed successful programs tailored to meet the needs of patients, payers and physicians. These programs continue to be improved and new programs developed as more resources become available and infrastructure is built to support the new advances.

The physicians of Oakland Physician Network Services (OPNS) have long desired to have an ownership interest and the ability for meaningful input into an accountable healthcare company, demonstrated in recent years by the interest in purchasing Ultimed and ProCare and exploration of founding Greencare, LLC in collaboration with Midwest Integrated Health (MIH), a group of IPAs. This desire has led the OPNS physicians to submit this OPNS application under their select physician subsidiary Physician Direct ACO for becoming a shared savings model ACO. It should be noted that OPNS under OPNS Enterprises, LLC also maintains the “Certificate of Assumed Name” in the state of Michigan to transact business under the names “Physician Direct Accountable Care Organization”, “Physician Direct Organized System of Care”, “OPNS Enterprises, LLC” & “Physician Direct System”. The Physician Direct ACO physicians and administrative staff have extensive experience in physician network management, risk assumption, medical and case management, physician profiling and physician credentialing. The Physician Direct ACO physician partners expect to produce shared savings to earn an operating profit and a return on their capital investment through the creation of efficient operating processes, prudent contracting with their peers and reasonable pricing to the consumer. OPNS has held a profitable Blue Care Network (BCN) risk agreement for 10 years with only one year failing to produce profit. Losses were paid back to BCN according to the contract and as agreed upon.