When should primary care groups become multispecialty networks?

A difficulty confronting many primary care groups is determining whether--and when--to evolve into multispecialty networks. Internal triggers that signal the need to transition to a multispecialty group include having a sufficient number of primary care physicians in the group and the solidification of an effective primary care management system. External triggers include a decline in average per-member-per-month (PMPM) rates, carve-outs of portions of the PMPM payment for an increasing number of healthcare services, and increases in Medicare managed care enrollment. Primary care groups that make the transition to multispecialty networks may find it is the best model for managing the health of the population in their community.