The Practice Perspective

Middle Tennessee’s largest, independent, multi-specialty practice is getting a little bigger with the announcement that Heritage Medical Associates is acquiring Summit Medical Associates.

The deal, which was announced in mid-December, creates a combined entity with 14 locations in six cities across three counties with 136 providers serving an active population of 150,000 patients. With the acquisition, Heritage Medical Associates will have physicians and advanced practice providers in 15 specialties including four primary care specialties – family practice, internal medicine, pediatrics, and combined internal medicine and peds.

Chetan Mukundan, MD, FAAP, president of Heritage, noted the deal was almost a decade in the making. Recently approached by Summit’s physician leader William Baucom, MD, the genesis of the merger started many years earlier. “There is a history where Heritage and Summit had previous discussions about nine years ago, but the consensus was the timing wasn’t right then.”

What the two groups did realize during those early meetings was how closely aligned their practice philosophies were. “It’s like looking in a mirror,” Mukundan said. That belief has been reinforced over time as the two worked together as part of the Synergy HealthCare accountable care initiative.

“We have followed the success of Summit for many years. The practice’s holistic approach to patient care, coupled with their primary care emphasis and dedicated, professional team, directly align with our business model,” Mukundan said.

He noted, “We realized that their culture is very similar to our culture. What made this stand out is they practice very similarly to us. The goal is quality care delivered at a lower cost.”

Despite the good fit however, Mukundan said the decision to join forces wasn’t made lightly on either side. “The due diligence was unbelievable,” he said. “We investigated this incredibly thoroughly; but the more we looked at it, the more it made sense”

The similarities extended beyond the philosophical to the practical. “The two organizations are using the same electronic health system, which will make the transition seamless,” Mukundan said, adding both practices have in-house IT professionals who are working together on the data migration. Mukundan said the resulting larger practice also benefits both groups by combining some administrative functions and by lowering overhead through increased volume. “There are resources we have that will benefit them, and resources they have that will benefit us,” he added. “As we grow together, we will leverage our insights and expertise to benefit the patients and communities we serve.”

For Heritage, those benefits include adding the specialty of hospital medicine to the practice and extending their geographic reach into the Hermitage and Mt. Juliet areas of Middle Tennessee. “It was a part of town where we weren’t engaged at all,” Mukundan explained.

While this merger made sense, Mukundan said he didn’t foresee Heritage routinely absorbing other practices. “I don’t think our goal is to take over Nashville healthcare,” he said with a laugh, adding it would have to be the right practice at the right time to consider another acquisition. But, he added, “We’re always willing to listen.”

Whether or not Heritage partners with other groups in the near future, Mukundan said the practice would continue to seek methodical, intentional opportunities to grow. The shareholders, he noted, regularly evaluate the need to add specialties or expand those already being offered.

“We try, as an organization, to allow individual departments to have the say on those sorts of growth issues,” he said of increasing clinical staff and services. “If the individual departments are spearheading those decisions, it’s always more effective.”

Stability is another important consideration. “We’re always looking to the future. We know we have doctors in the twilight of their careers so we have to have a game plan to make sure patients stay covered,” he said of succession planning. Another growth consideration is strategically expanding the practice’s geographic catchment area to reach new patients.

While many practices and physicians have opted to become hospital employees, Mukundan said the merger of Heritage and Summit is an example of how multi-specialty practices can not only survive but thrive. With a robust infrastructure in place and a good relationship with hospitals across Middle Tennessee, the physicians enjoy the flexibility that comes with being independent. “We can see our patients where they need to be seen and send them where they need to go,” he said, noting he routinely sees patients at three different area hospitals.

“I think the physicians all cherish the fact that we’re independent,” Mukundan concluded. “We can’t fathom relinquishing that because it’s part of who we are.”