Taking Full Risk

Abstract

In this chapter, the author describes an opportunity to take “full risk” as a geriatric primary care practice. He opens with how the opportunity to buy an existing practice came about and what type of due diligence went into buying the practice. Details about the necessary decisions that were required followed by the process of meeting with the existing medical staff are shared. The importance of focusing on the geriatric approach and model of care is highlighted. Decisions about specialty capitation and where to give and take in developing business relationships in the market are discussed. The history of how major decisions regarding information systems and care coordination were made is reviewed. The author reviews the highlights of a few weeks of hospital rounds to describe how the geriatric model impacted hospital days per thousand numbers. The chapter closes with a discussion on the importance of aligning incentives.