Donna Walker, CEO, IMA Medical Group

In an interview with Invest:, Donna Walker, CEO of IMA Medical Group, shared how IMA is positioned to adapt to evolving healthcare trends and challenges by prioritizing individualized patient care, leveraging innovative technology, and addressing workforce shortages. 

What have been some major highlights over the past 12 months for IMA Medical?

Probably the most notable achievement is our growth. We are outpacing the market by almost 6%. Our growth so far this year has been 5.8%, whereas the market’s growth is only 0.2%. Additionally, we have added a number of important services for our patients, including X-ray, fundoscopy, ultrasound, in-house cardiac services, enhancements in our wellness centers, and a personalized diabetes program. 

Diabetes is the No. 1 chronic disease affecting our patients. As such, we have created a program where they have individual diabetic coaches to help bring their A1C levels down, which keeps them out of the hospital and at home.

How does IMA customize treatments and care plans to meet individual patient needs in light of the growing prominence of personalized medicine?

Our new patient experience is a good example of this. We typically welcome around 500 new patients per month, in addition to our legacy patients. When a new patient joins us, we promptly reach out to them to discuss their needs. Our care managers, who handle this initial contact, engage in conversations to understand their requirements. Within the first 30 days, we schedule an appointment with one of our providers, who spends 45 minutes to an hour comprehensively assessing their needs.

Following this assessment, we craft an individualized treatment program tailored to their specific requirements. This could involve enrollment in our diabetic program, cardiology program, or recommendation to utilize our wellness centers. These centers play a vital role not just in physical health but also in addressing social and mental well-being. Depending on the patient’s condition, the frequency of visits varies. For relatively healthy patients, visits may occur once or twice a quarter. However, for those with multiple chronic conditions, such as diabetes, PAD, PBD, cardiac issues, and potentially mental health or social issues, we recommend visits at least twice a month to ensure comprehensive care.

Mental health is a significant concern, being one of the largest causes of hospitalizations, particularly in Florida, due to the substantial dual population. Therefore, we prioritize addressing mental health alongside physical health needs. Our care managers maintain regular contact with patients, regardless of their risk level or specific needs, ensuring they receive support and guidance at least once a month.

Given the critical role of mental health in overall well-being, what innovative approaches is IMA adopting to address mental health challenges?

We are collaborating with a vendor to implement in-house and virtual mental health services for our qualifying patients. This program entails regular mental health check-ins lasting at least six months, with the option to extend as needed. It’s a personalized approach that involves engagement with social workers, psychologists, and psychiatrists. Depending on the patient’s risk level, touchpoints occur once or twice a week, once or twice a month, or monthly throughout the program duration.

Most of our clinics are equipped with patient pod rooms where patients can have consultations with specialists via a large screen. This setup allows for seamless integration of mental health appointments alongside regular checkups with our providers, whether it be with a cardiologist, endocrinologist or a mental health professional. We are actively working on this initiative, collaborating with vendors, such as Janus and Brightside Health, aiming for implementation by the latter half of 2024.

Regarding the virtual aspect, patients can participate from the comfort of their homes. This is particularly beneficial for those with transportation challenges, although we do offer transportation assistance for in-person appointments if needed.

How is IMA utilizing evolving healthcare technology, such as data analytics and artificial intelligence, to enhance patient outcomes?

On the technological front, we are piloting a program where AI, in conjunction with a live nurse, contacts our patients from a care management standpoint. This innovative approach allows for more touchpoints with patients while also reducing staffing costs. It’s a promising endeavor that we have personally tested through demos, even assuming the role of patients to ensure its efficacy. So far, the results are promising, and we plan to expand it to more clinics in the future.

Another exciting development is the integration of AI into our X-ray machines, enabling early detection of chronic conditions like congestive heart failure (CHF), vascular disease, and pulmonary fibrosis. Unlike traditional methods, AI is not constrained by provider instructions and looks for everything, which allows us to identify various abnormalities, leading to a 65% increase in early disease detection. Similar advancements have been made with our echocardiograms, resulting in a 30-40% improvement in early CHF diagnosis.

In terms of personnel, two key hires, our head of risk adjustment and head actuary, have significantly contributed to our success. Their expertise has enabled us to analyze diagnostic and claims data with unparalleled granularity, allowing us to identify high-risk patients early on. This level of detail empowers us to address systemic issues, whether they stem from patient behavior or provider practices.

Speaking of patient behavior, our diverse patient population, including many from Puerto Rico, has unique healthcare needs and perceptions. Patient education plays a crucial role in steering them toward appropriate care settings, reducing unnecessary ER visits, and promoting cost-effective healthcare solutions. Through targeted interventions and personalized care, we strive to improve patient outcomes while optimizing healthcare costs under Medicare Advantage.

Our goal can then be broken into two parts: to prioritize the best health outcomes for our patients at the least cost through individualized care, and data-driven analytics. By leveraging technology and fostering patient engagement, we aim to enhance the overall quality and cost-effectiveness of healthcare delivery.

How has the ongoing workforce shortage in the healthcare sector impacted your organization?

Healthcare shortages have improved compared to previous years. While we faced significant challenges in hiring during 2020, 2021, and early 2022, we are no longer struggling to fill positions. The new challenge now is the dramatic increases in healthcare wages. This shift poses a considerable challenge to providing cost-effective care, especially when frontline staff wages have surged by as much as $8 per hour.

Previously, our competition primarily comprised other healthcare companies. Now, we find ourselves competing with a broader range of industries, including tech giants like Google and Amazon, as well as retail establishments like warehouses, gas stations, and even fast-food chains like McDonald’s, which is reportedly offering $22 per hour. While the return of workers has alleviated some of the shortages, the primary concern now is the competitiveness driven by substantial wage increases.

What trends do you anticipate in healthcare over the next five to 10 years, and how is IMA positioning itself to adapt to these changes?

That is a tricky question because the trajectory of healthcare trends has been toward innovation, personalized care, prioritizing wellness over illness, and addressing social determinants of health, particularly in mental health. However, a recent radical change in reimbursement by Centers for Medicare & Medicaid Services (CMS) could potentially disrupt these trends. If CMS continues on this path, it may hinder the progress made in innovation, personalized care, and mental health initiatives.

Nevertheless, if CMS pivots, the focus will likely remain on innovation, personalized care, and mental health, including addressing social determinants of health. The emphasis will continue to be on keeping patients healthy and providing tailored care. Despite potential challenges, advancements in AI and technology will persist, driving improvements in healthcare delivery. However, without CMS support, there is a risk of losing momentum in areas like innovation, social determinants of health, and personalized care.

In what ways do state, local, and federal government policies support your ability to provide care?

While state and local governments play significant roles in supporting us, it’s the federal government that requires attention. We rely heavily on the support from our community and state and local governments, especially in caring for our seniors. However, I am deeply concerned about the future of seniors’ care without radical policy changes at the federal level. It’s crucial that we advocate for and push for these changes to ensure the well-being of our senior population.

Lastly, I want to emphasize that at IMA, we have a profound love for our patients. if you do not have this attitude, you do not stay long in this business.