Cooper Care Alliance: Then and Now
When primary care providers choose a career in medicine, they’re probably not thinking about the electronic records they must code or the insurance company they need to call when medication for their patient gets denied. Providers go into medicine to save lives and improve the overall health of their patients.
That was the impetus behind the Cooper Care Alliance (CCA), a community-based physician group operated by Cooper University Health Care. CCA is an innovative model that enables primary care providers to do what they do best – patient care – by providing the administrative support they need for everything else in their practice. By utilizing the breadth and reach of the CCA group, providers benefit from increased resources while their patients enjoy expanded access to care.
“It was very forward-thinking of our co-CEOs, Anthony Mazzarelli, MD, JD, and Kevin O’Dowd, JD, as well as our Chief Physician Executive, Eric Kupersmith, MD,” says Carman Ciervo, DO, FACOFP. “They had the foresight, well over 3 years ago, to recognize that Cooper was not just about tertiary care and trauma, but about great access to primary care. Dr. Greg Taylor did a great job jump starting the initiative in Sept. 2020 with many of his associates following him.”
Changing the Model for Primary Care
Dr. Ciervo was one of the first administrators hired for the Alliance. He helped to formulate the strategy, based on his 30-year career in family medicine. “I’m from South Jersey. I grew up in South Jersey,” he says. “I’m committed to improving healthcare in South Jersey.”
He likens the CCA approach to keeping services in your neighborhood. “Particularly for primary care, which is so important, you want that same kind of access to your provider, right in your community. So over the course of 2 years, we now have offices in Burlington, Gloucester and Camden Counties – a total of 70+ providers.”
To attract the best and brightest candidates, CCA offered some compelling perks. “We had to be different than the other health systems,” says Dr. Ciervo. “Typically, when you leave a group, you are not allowed to practice medicine within that geographic location, maybe 10 miles or so. That forces practitioners to relocate. At Cooper Care Alliance, we have no restrictive covenant. If we’re not a good fit for our providers, they can leave without restrictions. We’re building a culture of trust, and that was very important to us.”
The team also widened the pool of candidates by lifting the academic requirement, notes Elizabeth Nice, MS, vice president, Cooper Care Alliance and Population Health. “In the past, there was only one way to join Cooper as a physician, and it was through the academic medical center,” she says. “We recognized that there are providers who enjoy providing care but are not ready to have residents in their practices.”
Providing the supportive infrastructure was key. “We enable them to really focus on the medicine while we pick up the other pieces, such as inventory, operations and billing,” she says. “As a patient going to your primary care practitioner, you may not have an appreciation of what it means to be supported versus being independent. With that extra support, there’s a renewed energy in the offices because everyone’s working at the top of their license. Patients can really see the difference.”
The approach was well received, according to Greg Taylor, DO, medical director, Cooper Care Alliance, who helps recruit providers. “We are creating an environment where we respond to the needs of the providers: the physicians, APNs and PAs,” he says. “We are their advocates. We help make their jobs easier and that trickles down into better patient care.”
“They get the best of both worlds,” adds Dr. Taylor. “They have access to Cooper specialists and subspecialists, and a level one trauma center that’s renowned in the region. They can use one of our scheduling advocates to get a patient in to see a Cooper specialist in a week versus months. There’s the private practice office feel, along with the benefits of a respected academic, medical institution.”
Access to Care When You Need It
Expanded access to care is a key part of the CCA mission. That’s what prompted the launch of Cooper Care Now, which offers appointments with CCA providers from 8 am to 8 pm, 7 days a week. Patients may choose from in-person or telemedicine appointments. If your provider is not working at the time of your appointment, the provider on duty has full access to your medical history. There’s seamless reporting back to your primary care provider so everyone stays in the loop.
“We don’t want patients going to random urgent cares and then getting lost in the shuffle afterward,” says Jonathan Shulman, MSN, APN, FNP-BC, Associate Medical Director at Cooper Care Alliance. “Patients do better when they see their primary care provider, someone who knows their medical history and who can follow-up on that visit. We’re a cohesive group here, all working for the benefit of our patients.”
It’s an ongoing process to expand access, notes Shulman. “While our focus is primary care, once we started developing this group, it was apparent that certain specialties had access problems and this was impacting patients’ health. Patients couldn’t get in to see an endocrinologist in a timely manner. It was the same with behavioral health. So those areas where patients struggled with getting access to care became part of our initiative. We added our own specialists in those areas.”
“Particularly since COVID, and just the way the world is evolving so quickly, I think there’s a lot of need for behavioral health,” says Shulman. “It can be challenging when primary care is separated from specialty care. Now our primary care providers sit across the lobby from the behavioral health group, and it just makes it so easy. It’s a warm handoff that gives the patients more confidence and involves less stigma. It’s the right time, right place, right care.”
Providing a healthcare experience that makes all patients feel comfortable is key to patients staying engaged on their health journey. CCA opened the Center for LGBTQ+ Health specifically for its most diverse patient group. Members of the LGBTQ+ community are welcomed by practitioners who understand their unique health needs. In addition to well visits and sick care, the practitioners work to address the societal pressures on members of the LGBTQ+ community that have led to higher rates of substance abuse, depression, anxiety, eating disorders and suicide attempts.
A Culture of Caring Throughout South Jersey
“It’s our culture that truly distinguishes us,” says Felicia Nesmith-Cunningham, MBA, administrative director for Cooper Care Alliance. “We really do represent ‘one team, one purpose’ from every area and touchpoint of CCA.” Nesmith-Cunningham oversees operations, from clinical to clerical, billing, scheduling and more. “Everyone is on the same page, all working for the benefit of our patients. It’s why they went into medicine in the first place. Which is why, even though there’s no restrictive covenant, once they join us, our providers won’t want to leave.”
Nesmith-Cunningham is not surprised by the unprecedented growth of the CCA. “It’s because of the leadership, and not just the executive team,” she says. “There are leaders at every level, and everyone plays a role in delivering quality care. At the end of the day, it’s all about providing quality care and ensuring that patients’ needs are being met, not just one day but every day. As a result, we can have a deeper presence of primary and specialty services throughout South Jersey.”
“Originally, we were hoping for 15 to 20 clinicians,” says Dr. Ciervo. “The fact that we are now over 70 speaks to the success of the Cooper Care Alliance.”
