Becoming a High-Performing Physician Enterprise

Most physician groups are struggling to keep pace with the evolving healthcare environment. Increasing demands and tightened resources are forcing physicians and ambulatory networks to rethink how they manage the health of their patient populations. High-performing organizations have a critical understanding of the strategic, operational, financial, and technological challenges they face and, more importantly, have a plan for overcoming these challenges. Watch the video below to learn more about what it takes to transform your practice into a thriving physician enterprise. Continue reading

Physician Integration – Physician Partnership Priorities: Delegation, Communication, and Negotiation

Virtually all hospital integration initiatives include physicians in administrative capacities (e.g., medical director) and the formation of a physician advisory committee to ensure doctors are included in at least some of the decision-making processes.  While necessary and important, these limited roles must evolve over time into a true partnership, with physicians being embedded in all financial, clinical, operational, and strategic aspects of the integrated network.  Creating an integrated system means combining two types of businesses into a single healthcare enterprise.  Establishing the physician partnership is the fourth and final phase of physician integration and involves sharing control and changing the historical culture for both hospitals and physicians.

This is more difficult than it appears, because hospitals and doctors frequently have very different goals and ways of operating prior to an affiliation.  Although this challenge is not specific to those organizations moving from Phase 3 into Phase 4, it is important that administrative and medical leaders recognize the motivational differences in order to effectively align and move forward.

Major differences in traditional hospitals and physician organizations include:

4Phases_Table1
While the table above may be oversimplified, the point is Continue reading

Physician Integration – Clinical Coordination Priorities: Physician Leaders and Care Coordinators

The ultimate goal of physician acquisitions is enhanced coordination of care and integration across the care continuum.  The sad reality is that most providers currently share very little clinical information with each other.  Diagnostic and/or therapeutic information from one location or encounter is often unavailable to others who treat the patient at another location.  In developing a physician network, the coordination of care is too often deferred until “later” because physicians and management are not comfortable with how to proceed.

First, it should be recognized that clinical integration is different than economic integration.  Clinical integration requires different operational activities and decision-making approaches than those of typical hospital systems.  It should start with Continue reading

Physician Integration – Operational Excellence Priorities: Practice Management, IT, and Compensation

After the initial rush to employ physicians, attention invariably turns to how to efficiently manage the employed practices.  This frequently happens when the financial drain of the practices reaches a level that the hospital or system deems unsustainable.  While the physicians are now employees of the system, it is often the case that the practices are not well organized or aligned within the system.  In some cases, large guaranteed compensation agreements are in place and physician practice management capabilities have not been built.  It is not surprising that in these situations the practices are not financially viable, nor is the physician network able to achieve its strategic goals (if goals have been identified).

The most expeditious way to overcome this hurdle is to transition as quickly as possible into optimizing operations, the second phase of physician employment.  In this phase, the physician enterprise develops its administrative core and builds skills around managing the practices, while continuing to grow the base of employed practices.  Continue reading

Physician Integration – Network Expansion Priorities: Marketing, Sales, and Planning

In our last post, we discussed the increase in physician integration and defined the four phases of successful integration. This post will focus on the first phase of integration:  Network Expansion and associated priorities.

Most commonly, hospitals’ early acquisitions are opportunistic purchases of primary care practices, key specialists who are close to retirement, or practices in need of financial rescue. Hospitals frequently scoop up the practices with the intent to figure out the best ways to grow and manage the network at some future date. This acquisition phase is both necessary and appropriate, as a fully developed network takes time and collaborative effort to create. Regardless of the initial reasons to employ physicians, as hospitals move forward, the reality is that the competitive environment and payor requirements get more complex, and the pressure to grow the network intensifies. Whether it involves primary care physicians or specialists, hospitals cannot let their admitters be recruited by competitors and must bring needed providers and services into the network. Growing a network entails Continue reading