Dr. Gilbert Simoni co-founded Choice Health Associates. The group is a loose affiliation of physicians in private practices who have teamed up to pool marketing resources in an effort to better compete with UCLA Health System and other large providers. (Alex Drysdale photo)

About 100 doctors in East Ventura County are fighting for their independence by working together.

They’re members of Choice Health Associates, a loose affiliation of physicians in private practice who have teamed up to better compete with big out-of-town providers. The biggest of those competitors in the Conejo Valley is UCLA Health System, which has opened offices in Westlake Village and Thousand Oaks over the past two years.

UCLA, Kaiser Permanente and other large organizations have the advantage of economies of scale in billing and other administrative functions, and they have more power than small medical groups or solo practitioners when negotiating with insurance companies. They also benefit from certain provisions of the Affordable Care Act. UCLA is a particularly formidable competitor because of the strength of its medical brand.

“Once ULCA moved in, we knew we needed to do something to really unify ourselves,” said Dr. Susan Mayo, a physician with Arroyo Oaks Medical Group in Thousand Oaks and one of the seven board members and co-founders of Choice Health. “We recognized our need to have a better voice, to really market the physicians in private practice better, because we don’t have that visibility that you have with a large organization.”

Choice Health is, essentially, a marketing cooperative. Its doctors pool some of their money for advertising, but they remain autonomous in their medical and business practices.

Mayo said the 100 or so members each pay $1,000 a year to belong. That pays for a website to help patients find a doctor in the group, and a marketing campaign that launched recently with a spate of print advertisements.

“Already, just from running one ad, we’ve got a lot of calls to my office,” Mayo said.

Doctors in Choice Health also work together to refer patients to each other. The competition from UCLA and other big organizations has pushed them to offer same-day appointments through a single phone number, just as the large networks do.

“What happens is that UCLA hires a lot of different physicians, and they have better availability because these physicians are coming in with no patient load,” said Dr. Gilbert Simoni, a gastroenterologist in Thousand Oaks and another Choice Health co-founder and board member. “If my next appointment is in a week or two and they can provide a same-day appointment, the patient is going to choose the same-day appointment. We’ve smartened up and caught onto that, and now we have a call schedule so we can provide same-day appointments every day.”

It’s actually not difficult to compete with a large health-care network on price, Mayo said. The big providers can use their leverage to get more out of insurance companies for a procedure, but that raises the price for the patient, if the patient’s copay is set at a certain percentage of the cost of a procedure.

Johnna Hensley of Agoura Hills was a UCLA patient for a while and found the experience frustrating. “The doctors themselves were great,” she said. “It’s the rest of the whole UCLA experience. The customer service was not good. … I had prescriptions to transfer over, and they just wouldn’t do it. I called for weeks and I couldn’t get anyone to call me back.”

Dr. Matteo Dinolfo, the medical director for the UCLA Department of Medicine’s community offices, wouldn’t talk specifically about the competition from Choice Health. But he said the new offices in the Conejo Valley have been very successful, as have new offices in Porter Ranch and Santa Clarita. UCLA plans to open in Calabasas later this year.

Hensley also wasn’t happy with how often she was sent to another doctor when hers was unavailable, and she said she paid far less out of pocket when she was with a doctor in a small private practice. She and her husband are now back with a small practice.

“Patients choose where to go based on where they think they’re going to get the best care, and we’ve made it fairly simple for them because we work with local hospitals,” Dinolfo said. “They have UCLA-quality care in a local environment, and I think patients like that.”

Consolidation is everywhere in the industry, and UCLA is just one threat to small practices. Simoni said he’s been in touch with doctors who have started associations similar to Choice Health in the Midwest and on the East Coast.

“My vision is that at some point they’re going to come together, and we will try to create a national organization,” he said.