The Verden Group

Independent Integrated Networks: What You Need to Know


Pearl | July 01, 2015 | Practice ModelsPayersPearlsPerformancePhysician Compensation

Many physicians are by now familiar with such terms as “clinically integrated networks” (also known as CINs), but a slightly different model is beginning to emerge as independent practices resist being swallowed up by hospital systems, and physician organizations become more savvy. You can think of this model as a hybrid between the “super group” (or clinically integrated practice) model and the more familiar hospital-based offering whereby care coordination and data is managed centrally there. Rather, these independent integrated networks (IINs) are being driven by independent physician organizations, coalitions, and alliances between physicians themselves.

What is “clinical integration” anyway?

The Department of Justice and the FTC define clinical integration as an active and ongoing program to evaluate and modify practice patterns by the CIN’s physician participants and create a high degree of interdependence and cooperation among the physicians to control costs and ensure quality. Generally, the FTC considers a program to be clinically integrated if it performs the following:

1. Establishes mechanisms to monitor and control utilization of healthcare services that are designed to control costs and ensure quality of care;

2. Selectively chooses CIN physicians who are likely to further these efficiency objectives; and

3. Utilizes investment of significant capital, both monetary and human, in the necessary infrastructure and capability to realize the claimed efficiencies.

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State Pediatric Medicaid and CHIP Medical Home Initiatives: At-a-Glance Table

statemapThe National Center for Medical Home Implementation (NCMHI), in partnership with the National Academy for State Health Policy (NASHP) has created a state at-a-glance table which provides an overview of pediatric medical home initiatives occuring through Medicaid and the Child Health Insurance Program (CHIP).

By learning about ongoing pediatric medical home initiatives in your state, pediatric clinicians, practices, state Title V agencies, American Academy of Pediatrics chapters, and others can gain insights on how to integrate their work and coordinate efforts across multiple systems.

Click here to view or download the state at-a-glance table.


Forming a Medical Practice ‘Super Group’


Pearl | September 03, 2014 | Practice ModelsManagers AdministratorsOperationsPearlsReferrals

We have seen an enormous consolidation in medical practices across the industry in the last three years. Many practices are being bought out by hospital systems in preparation for laying the groundwork for accountable care organizations and for building market share in the new value-based purchasing environment.

But rest assured, the independent practice is alive and well — there are practice models available that allow physicians to operate independently, while coming together as one entity to reap the benefits of cost efficiency. One way physicians can reinvent their practices, is to become a “super group.”

Looking for more ways to boost performance at your practice? Join experts Rosemarie Nelson, Lucien W. Roberts, Owen Dahl, and others as they help improve your medical practice and your bottom line atPractice Rx, a new conference for physicians and office administrators. Join us Sept. 19 & 20 in Philadelphia.

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Patient Portals Can Help You Meet Medical-home Criteria


Pearl | October 08, 2014 | Patient PortalsMeaningful UsePatient RelationsPearlsPractice Models

If you are thinking about implementing a patient portal, or already have one in place, you may not realize that this is a great tool to help you meet certain criteria necessary for achieving Patient-Centered Medical Home (PCMH) recognition.

Many portals offer the components required to meet part of the National Committee for Quality Assurance’s (NCQA) PCMH Standard for patient-centered electronic access. The purpose of doing so is to allow the practice to offer information and services to patients and their families via a secure electronic system whereby patients can view their medical record, access services, and communicate with the healthcare team electronically.

Providing electronic access to this information also enables practices to meet meaningful use requirements, so you get a double return on your portal investment if you are attempting to meet requirements for both the NCQA PCMH and meaningful use programs.

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New Practice Models Are Gaining Acceptance in Primary Care


August 20, 2014 | Great American Physician SurveyPatient RelationsPhysician CompensationPractice ModelsWork/Life Balance

Manhattan cardiologist Arthur Weisenseel has enjoyed a long and satisfying medical career; one that encompassed teaching at New York-based Mt. Sinai Hospital, running a successful cardiology practice with another physician, and stewarding his aging patients into a healthy old age. But, somewhere in the last five years to 10 years, his practice became problematic. Weisenseel says that despite working as hard as he could, he wasn’t able to consistently pay both practice expenses and himself. He says of that time, “I worked awful hard to get [there]. And to go home without reimbursement was becoming demoralizing.”

So, like a growing contingent of like-minded physicians, Weisenseel decided to explore other practice models. Encouraged by his patients and positive conversations with colleagues, he has now successfully converted his practice to a hybrid-concierge model, where patients can choose to pay an extra fee for concierge services or continue to reimburse him through traditional insurance plans like Medicare and third-party payers. Now he couldn’t be happier: Relieved of worries about financial and regulatory burdens, he says, “I come to work with joy and confidence.”

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Patient-Centered Specialty Practice for Specialists


While still in its infancy, word about the National Committee on Quality Assurance’s (NCQA) medical home program for specialists is spreading fast. The program was released last March and appears to be gaining considerable momentum. We receive inquiries daily from practices asking how we can assist them with meeting the program’s standards; from gastroenterologists, oncologists, nephrologists, orthopedists, even ophthalmologists.

Unlike the primary-care Patient-Centered Medical Home (PCMH) program that has taken several years to become firmly established, it appears that specialists are “early adopters” of this new similar program — Patient-Centered Specialty Practice (PCSP) — designed especially for them.

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NYS Insurance Price Wars


One of the puzzling questions about the Health Insurance Exchanges (a key component of the Patient Protection and Affordable Care Act) is, “How can the same products have such variations in premium pricing?” Differentials of between $200 and $500 a month are noted for the same metallically labeled products.  Why the difference? Answer: the insurance carrier.

The lowest prices have been associated with the newest entrants into the NY market, Heath Republic and OSCAR. The established payers, such as Empire and, in particular, United Healthcare, were priced at the high end.

Since all products are essentially the same in terms of benefits, the difference would be in the costs of the network that supports the payer’s product and the pricing philosophy of the company.

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The Verden Group is delighted to welcome Paul Vanchiere, MBA, and Sumita Saxena, JD, to our consulting team.

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With over 15 years of healthcare management experience, Paul Vanchiere joins The Verden Group to provide our clients with financial and operational practice consulting; Sumita Saxena, admitted to the California State Bar in 2000, brings her legal focus to the Group in the capacity of business consulting services.

“The addition of specialized consultants Paul and Sumita means our service offerings are more comprehensive than ever,” says Susanne Madden, CEO and founder of the Verden Group. “Their combined expertise ensures our clients have the benefit of expert business advice and practice management tools. Sumita’s focus ranges from guidance on employment laws, to negotiation and language interpretation for insurance contracts. Paul offers a unique financial analysis of Pediatric practices, including onsite assessment, that gives our clients the tools to meet every day challenges more efficiently at a price they can afford.”

To learn more about Paul Vanchiere and Sumita Saxena, and to read more about these new offerings from The Verden Group please click on the links below.

More on Paul Vanchiere:

More on the Complete Pediatric Practice Assessment:

More on Sumita Saxena:






The Verden Group welcomes Paul Vanchiere to our team.


The Verden Group is pleased to welcome the founder of the Pediatric Management Institute, Paul Vanchiere (MBA) to our team. With over 15 years of healthcare management experience, Paul joins The Verden Group to provide our clients with financial and operational practice consulting.

Currently working exclusively with Pediatric practices, Paul’s past experience with cardiology and pathology practices, as well as physician practice acquisitions for the largest non-for-profit hospital in Texas, adds a unique depth to our client services. For the past five years, Paul has worked on financial and management issues for a physician group of over 200 general Pediatricians.

Paul_Vanchiere“Paul brings considerable experience to our group. As a speaker on a range of pediatric practice management issues and with a national portfolio of clients, his extensive knowledge of practice dynamics will play a pivotal role in our efforts to provide unparalleled service to our clients,” says Susanne Madden, founder of The Verden Group. “Paul’s seasoned practice management expertise allows us to provide our Pediatric clients with the tools to not only meet every day challenges, but to do so successfully as the healthcare environment continues its dizzying pace of change.”

Paul will focus on a unique service that provides a full financial analysis of Pediatric practices along with an onsite assessment for a nominal fixed price. According to Paul, “Pediatricians often have limited resources to invest in such engagements. I am extremely sensitive to their investment of time and resources in what we do for them. I strive everyday to provide tangible advice on how to manage their practice properly.”

Paul can be reached at and more information about these services can be found here.

The Verden Group Brings a Legal Context to Guidance on Business Matters


The Verden Group is very pleased to announce the addition of Sumita Saxena, Esq., to our consulting team. Admitted to the California State Bar in 2000, Sumita brings her legal focus to the Group in the capacity of business consulting services, specializing in matters such as practice agreements, guidance on employment laws, and negotiation and language interpretation for insurance contracts.

“The addition of Sumita to our team brings the level of services we provide up another notch,” says Susanne Madden, CEO and founder of the Verden Group. “We’re not a law firm. We work in a strictly non-legal, business-only capacity when advising clients but the fact is that legal issues are a part of doing business in healthcare today. Sumita’s expertise ensures our clients have the benefit of expert business advice on these matters and are guided appropriately as to when to seek legal counsel.”

With current experience as in-house counsel for a medical group, Sumita has the hands on expertise required to confidently advise Verden’s clients on the development of sound business operating procedures and practices from a legal perspective. Sumita also has extensive experience working on employment matters, workforce & performance management, and human resources management.

She is located in Redwood City, CA, and can be reached at