Heart Center Cardiology, a comprehensive cardiovascular care clinic in Bend, is dissolving, and several of its care providers will join the St. Charles Medical Group to be employed by St. Charles Health System, starting in July.

Together, the Heart Center Cardiology practice and St. Charles built The Heart Center, a building located on the St. Charles campus, with a vision of collaborating on a continuum of cardiac care services, said Dr. Michael Widmer, a partner in Heart Center Cardiology. The two organizations had hoped to integrate to the point of sending patients just one bill, he said.

But a variety of factors, including, for example, Medicare reimbursement rules, made it difficult to truly integrate. Heart Center Cardiology is a for-profit organization, while St. Charles is a nonprofit, so they run differently.

Care providers from the two organizations did work together in patient care, Widmer said, but starting July 1, the two groups will no longer be competing for volume or revenue, which are among the “practical business realities in medicine.”

“We are on the same team now,” said Dr. Jeff Absalon, chief physician officer for St. Charles Health System.

“By bringing these separate groups together under one practice, we will streamline care for our patients and improve communication between providers with the end goal of improved patient outcomes,” he said.

Widmer, who serves as president of the American College of Cardiology for Oregon, said 70 percent of private practice cardiac groups are joining big health systems these days. The trend is connected to health system reform, which includes a move away from volume-based reimbursement and toward outcome-based reimbursement. Medicare, for example, is changing how it reimburses for readmissions, when patients return to the hospital soon after being discharged. Providers want to reduce readmissions. The best way to optimize patient outcomes — which should reduce readmissions — is to integrate with larger systems, Widmer said.

“Bigger doesn’t represent better, per se. Being bigger isn’t the goal,” Widmer said in a follow-up email. “Being integrated is the goal. Integration means: less fragmented and duplicated care; more team-oriented, patient-centered care; more efficient, better value care at lower cost per capita. Integrated systems become bigger as a result. Integrated systems are better as a result.”

In a “heart team,” cardiologists, surgeons and others involved with a patient’s care will make collective decisions about a patient’s best interest, he said.

The cardiologists who currently work at Heart Center Cardiology who are joining St. Charles Medical Group include Widmer, Hugh Adair, Bruce McLellan, James Laughlin and Eddy Young, according to a news release from St. Charles. Also transitioning to St. Charles will be Cassie Dixon, a physician assistant, and Nancy Hilles, a family nurse practitioner. They will be co-located with cardiothoracic surgeons John Blizzard and Angelo Vlessis — doctors currently employed by the St. Charles Medical Group — to create a comprehensive heart care team. Patients often see both cardiologists and cardiothoracic surgeons.

The group will be located in the current Heart Center Cardiology space on the third floor of The Heart Center. The building’s name may change in the future but specifics are still undecided, according to a spokeswoman.

All the cardiologists with Heart Center Cardiology were given the option to be employed by St. Charles, Widmer said, but for various reasons such as life circumstances or a desire for more autonomy, some opted out.

Heart Center Cardiology’s Dr. Jason Wollmuth, for example, is going to join a growing cardiology team at Bend Memorial Clinic, BMC announced on the same day that St. Charles released its plans. BMC is a multispecialty care group in Central Oregon.

Dr. Nahel Farraj, a cardiologist from Central Arizona Heart Specialists in Chandler, Ariz., will also join Wollmuth at BMC in July.

BMC’s cardiology services will now encompass a spectrum of care, with providers specializing in noninvasive, interventional and electrophysiology cardiology, said Dr. Sean Rogers, BMC’s medical director, in a news release. BMC’s cardiology team has centered on noninvasive and electrophysiological care, but Wollmoth and Farraj both do interventional work, such as stents and angioplasty.

“This is an extension of services we provide, to offer more comprehensive and coordinated care,” said Christy McLeod, BMC’s chief marketing officer.

Adding interventional cardiology was the next step for BMC’s cardiology care, she said.

“As we began the process, we quickly learned that Dr. Wollmuth would be available, and around the same time met Dr. Farraj. We were impressed with both physicians and their skills and made the decision to bring both physicians into BMC at roughly the same time,” she said.