History

Original formulation of Cornerstone began with Wapakoneta area family physicians during 1994 and 1995. Several physicians including Doctors Stienecker, Freytag, G.Herman, P. Herman and Cummins discussed the growing trend that insurance companies were requiring patients be sent to non-Lima area specialists. As a result procedures such as colonoscopies, total hips and orthopedic procedures were being sent to Columbus and Dayton. Businesses in Wapakoneta and south of Wapakoneta had panels of specialists formed that did not include Lima area specialists.

Wapakoneta physicians had discussions with St. Rita's Medical Center in Lima, Ohio, about how to prevent medical care from being leeched out of the service area. Initial discussions were undertaken to come up with solutions on how to provide specialty services upon a local basis.

Shortly thereafter, Lima area primary care physicians were also included in the discussions.  The physicians and St. Rita’s Medical Center administration reviewed developments such as contracting, physician/provider panels (then a new concept), capitation, avenues of working with insurance companies and employers to keep care local.

Area primary care physicians soon realized that they could not raise sufficient capital to form their own insurance company or HMO.  St. Rita’s Medical Center personnel then suggested the formation of a Physician Hospital Organization (PHO) to address some of the issues.  Due to the failure of a previous managed care organization in the Lima area and the failure to merge the two Lima hospitals, Cornerstone Alliance was incorporated with two owners, St. Rita's Medical Center and West Central Ohio Primary Care Physicians, Inc. (WCOPCP, Inc.).

Cornerstone Alliance's original Mission Statement is still in effect. The basic thrust is to ensure that future residents in the six county Lima service area are able to receive health care locally, with good access, competence, and affordability.

Over time the two ownership entities of Cornerstone Alliance amended the bylaws to change the Board of Directors structure to allow specialist physicians to participate in governance.  The current board structure is composed of six members from each "owner" (i.e. St. Rita's Medical Center and WCOPCP), two of which are allocated to specialist physician members from the community. The other four board members on each side are provided from members of St. Rita's Medical Center and WCOPCP, respectively.

Cornerstone Alliance is a messenger model PHO and has a compliance program to insure that the organization operates within all Federal Trade Commission (FTC) guidelines.  There are nearly 400 physician/provider dues paying members in Cornerstone.  Cornerstone's most important functions involve contracting with payer organizations for the services of the member physicians and credentialing the contracted physicians. Cornerstone contracting has reduced the need for each physician office to individually negotiate contracts with numerous insurance companies.

Contracting is based upon guidelines that were created with input from St. Rita's Medical Center, physicians (both primary care and specialists) and community businesses.  Cornerstone, at the end of 2004, has 29 payer contracts in effect with an average participation rate of 89% of physician members.

The Cornerstone credentialing process has also aided providers because Cornerstone personnel visit the individual physician's office and conducts the office and record reviews once every two years rather than having each insurer visit the physician offices to do its own review.

In addition to sponsoring several educational programs for physician office staffs each year, Cornerstone will also be initiating an audit program during 2005.  This program will for an additional fee allow practices to validate that they are being appropriately paid for the services that they provide for Cornerstone contracted payers.  Efforts are currently underway to provide additional shared services to member offices that would allow for cost savings and allow for rebates of paid dues.