PMA Salutes Mark DeRubeis 2012 Recipient of the PBT Diamond Award

Mark DeRubeis shapes vision for Premier Medical Associates

Health insurer Highmark Inc. shed Premier Medical Associates in 2004 after deciding to get out of the medical provider business, the same year Mark DeRubeis was named CEO of the medical group — and diagnosed with cancer.

Seven months of radiation and chemotherapy followed, which ultimately was successful. Beating cancer was his biggest personal challenge, DeRubeis said. With that behind him, he took aim at his biggest professional challenge by shaping a vision for Premier as a value-driven provider of medical services, a goal proving remarkably prescient.

The effort continues even after Premier was reunited with Highmark in an affiliation agreement reached in January.

“One of my goals is to have the city of Pittsburgh have access to large, multispecialty medical groups, which have the synergy and resources to try to improve high-quality care at the lowest possible cost,” DeRubeis said. “We didn’t invent this model, but it really is a commitment.”

Premier’s model was developed in 2005, when the practice had more vision than cash to pull it off. The idea was to create a practice that was quality rather than volume-driven, a break from the standard medical practice business model, but one that Medicare and most commercial insurers have begun touting as their own.

Premier’s board agreed to pool all reimbursement for providing care, then distribute it to doctors according to each one’s success at meeting quality metrics, DeRubeis said. Revenue from ancillary services, such as sleep-lab studies, was earmarked for capital improvements, including office improvements and electronic infrastructure.

DeRubeis makes the formula sound easy, but reaching consensus among doctors can be a challenge.

“Communication is key,” DeRubeis said. “Everybody needs to know what the expectations are. When you’re in an organization in growth mode, you’re very often starting from scratch. You really need to keep everybody on the same path.”

Dr. Michael Steinfeld, a Premier cardiologist who has known DeRubeis for 10 years, credits his success with his ability to listen and effectively communicate a range of options to board members.

“The real key is he listens — and that’s a wonderful talent,” Steinfeld said. “He’s also a very good speaker, a persuasive speaker.

“He’s a good organizer, a good collector of data and a good communicator in a down-to-earth way.”