Time to Revisit – and Reboot – Your Affiliation Agreement

Children’s hospitals and academic institutions have traditionally enjoyed a mutually beneficial relationship. For hospitals, prestigious affiliations result in an enhanced reputation and the chance to attract top physician talent. Medical schools, conversely, gain access to a specialty hospital for teaching, clinical training, and research.

This arrangement has been such a natural fit for so long that the agreements governing such relationships often go unexamined. “If it isn’t broken”…right? A partnership between a children’s hospital and medical school might not be broken, but in an industry marked by constant change, long-standing agreements may now be outdated and irrelevant.

As research funding becomes more competitive, GME funding remains flat, and subspecialty physicians are in short supply, the importance of well-functioning academic affiliations has come into sharper focus. Advanced agreements are driving greater clinical integration, and aligning those agreements with an organization’s comprehensive strategy can link teaching and research to the design of clinical programs and population health management. But older agreements that have been in place for years or even decades may have become static documents that are mostly out of step with the transition toward value-based care. Monitoring and managing such agreements may be an afterthought to the parties involved, but a review could reveal affiliations that are loose or assumed rather than formally codified and enforceable.

The existence of informal affiliations might indicate that the relationship between the partners is not mutually beneficial enough to formalize. Or it may mean there is a historical and valued relationship that hasn’t required a complete definition to date. However, neither children’s hospitals nor academic institutions can afford to have handshake partnerships that hinge on relationships between each organization’s leaders. Unless the arrangement is clearly defined and the details and benefits documented, new leadership may question the partnership or interpret the relationship differently.

The environmental shifts affecting hospitals and health systems present an opportunity to reexamine existing academic agreements and revise them to be more nimble and relevant in the era of reform. Affiliations between children’s hospitals and medical schools have long proved fruitful, and there’s no reason that has to change. But the world around these partnerships has evolved, so it’s time to dust off those agreements and ensure that they make sense in today’s market.

This post is the third in a four-part series that explores ways in which children’s hospitals are forming collaborative partnerships with physicians, health systems, academic affiliates, and research partners to thrive in a value-based healthcare environment. For suggestions on how to effectively review long-standing affiliation agreements, see ECG’s white paper titled How Collaboration Can Drive Success at Your Children’s Hospital.

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