Shann and Kelly Davis and family.
Shann and Kelly Davis and family.

The North Carolina Medical Society (NCMS) Foundation has joined with the Mountain Area Health Education Center (MAHEC) to help rural primary care practices in western North Carolina make the transition to value-based reimbursement.
Thanks to a grant from the Kate B. Reynolds Charitable Trust, the NCMS Foundation is able to fund this year-long pilot project, which offers select small practices free consulting through the Health Innovation Partners (HIP) team at MAHEC to help these practices thrive in the emerging value-based reimbursement models.
“This is the perfect thing for us,” says Shann Davis, PA-C, whose Country Clinic in Etowah is one of the first two practices selected to participate in the pilot program. “We need all the help we can get to stay afloat in the current health care environment.”
Davis’ wife, Kelly, the practice administrator adds: “We’re not a big hospital; we can’t pay for consulting services [to help us make the transition to value-based reimbursement]. We feel blessed we were picked for this.”
The MAHEC HIP team already has provided operational, quality and analytics support for over 100 practices in western North Carolina, including the Country Clinic, and the HIP consultants are well equipped to help practices navigate through the Medicare Access and CHIP Reauthorization Act (MACRA) and its Merit-Based Incentive Payment System (MIPS) as part of this pilot project.
The MAHEC team will assess each practice in areas including EHR optimization and access to and focused use of data; patient engagement; care coordination and population health; and financial sustainability including how to maximize current fee-for-service opportunities and the new payment models under MACRA. After assessing the practice, the team will come up with a strategic plan and help a practice team implement the strategic goals.
“Terri Roberts, who has been my representative consultant from MAHEC since 2010, contacted me about the project through NCMS,” said Sandra McCormack, MD, a solo practitioner in Tryon, and the second practice to sign on with the pilot project. [Terri] “has been my champion and is confident that I will be successful with the transformation to MIPS/MACRA.  The assistance with the NCMS project will be invaluable in achieving my goal.”
Both the Country Clinic and Dr. McCormack’s practice serve a mix of primarily Medicare with some Medicaid and self-pay patients. Kelly Davis said they have a fair number of patients who will pay the penalty for not having health insurance and pay cash for any service provided.
“Small independent practices take care of patients very well. Patients are not a number here,” Kelly Davis says. “They’re willing to pay cash because Shann really cares and they know that.”
Dr. McCormack agrees that a small independent practice can be good for patients as well as the medical professionals who work there.
“I opened my office Sept. 1, 1982 as a sole practitioner and have remained in this role since that time,” she says. “In the first four years I delivered babies and have watched them grow and even have their own children.  The rewards and benefits of rural living and becoming a ‘Tryon local’ have enriched my life.”
The advent of electronic medical records and the drive to new models of reimbursement through MACRA, pushed both of these practices early on to consult with MAHEC to keep up with the changes.
“My goal is to remain an independent practice as long as I can financially survive,” Dr. McCormack says. “That’s the hardest part about being solo, the challenges and pure economics of the current medical environment — operating a business, maintaining and documenting quality, ‘jumping through all the hoops’ and seeing one’s income decrease during the process.”
NCMS Foundation Vice President for Rural Health Initiatives Franklin Walker says the Foundation is committed to helping practices like Dr. McCormack’s throughout the state.
“We are very pleased to have these practices as part of our initial phase of this project,” Walker says. “We will begin recruiting practices for the piedmont and eastern areas of the state within the next month.”
Both Dr. McCormack and the Davis family hope the pilot project will help them successfully navigate these changes and serve as a model for other small practices.
As Shann Davis says: “In the long run it’s going to be better for patients and if we can benefit other small practices we’re happy to do it.”
If you would like more information about this project, please contact Franklin Walker at [email protected] or call 919-833-3836.