Best Practices for Physician Alignment

November 17, 2015
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As health care continues to shift toward an environment where payment is dependent on the patient’s entire episode of care, hospitals and physicians have more motivation to work together. To achieve successful physician alignment with your hospital, it’s important to choose the best fit strategy, create an appealing environment and get your team on board with your goals.

As health care continues to shift toward an environment where payment is dependent on the patient’s entire episode of care, hospitals and physicians have more motivation to work together. To achieve successful physician alignment with your hospital, it’s important to choose the best fit strategy, create an appealing environment and get your team on board with your goals.

Understanding the strategies
When it comes to physician alignment, you have some options. Some hospitals find it easiest to simply cultivate relationships with independent physicians, while others prefer to directly employ the doctors or create an integrated system. It’s all about finding what will work best for your situation.

One strategy is co-management, in which a group of physicians is paid by a hospital to manage a service line, described here by the Healthcare Financial Management Association.

“Once the co-management agreement was in place, we could sit down in an open environment and really debate the pros and cons, with the health system sharing its economic dilemma with us and us sharing our clinical dilemma with them,” Dr. John Mehalik, a partner in the Orthopedic Center of Florida who is also Lee Memorial Hospital’s medical director of the orthopedic service line, told HFMA. “The good news is that we still have an enormous choice as surgeons, but working with the health system, we were able to work directly with the vendors to get some of those costs under control.”

Accountable care organizations are another option. This is a more structured system where hospitals, doctors and other health care providers come together to coordinate patient care, a program promoted by the Centers for Medicare & Medicaid Services (CMS). Provider reimbursements are tied to the quality of the care that they provide to patients. The ACO is accountable for overall quality and cost during the episode of care.

Not ready to commit to an infrastructure overhaul? Consider developing contractual relationships with certain physicians or services to align patient care in a flexible way that still fosters alignment with your hospital. It’s a strategy that’s fairly easy and fast to set up and can provide either a short-term or long-term solution.

Fostering the right environment
If you want people to come to your party, you have to create the right environment. It’s basic hosting strategy. So if a hospital wants to increase physician alignment, creating the right environment is key. Foster provider leadership to give greater autonomy and recognition to your doctors, as well as provide team direction. Some hospitals even create leadership academies which include on-site sessions and online classes, HFMA reported. You don’t need to recruit leaders when you can grow the ones you have.

“Look for physician leaders who can participate in committees; listen to them and start nurturing their understanding of the broader organization’s work and the perspective of the board,” Dr. Peggy Naas, MBA, the vice president of physician strategies at VHA told Becker’s Hospital Review.

Encouraging a group culture among physicians is also important. The more providers work together with hospital counterparts, the more they’ll trust each other, which will consequently create greater willingness to work closely together on shared goals. It may also be worthwhile to throw a few social events to bring everyone together. Teams need to develop a shared history both socially and professionally to build trust.

Rally around a cause
You’ve found your physicians with the greatest potential, convinced them to work with your hospital in some form and fostered the right environment. Does that mean your job is done? Not quite. It’s critical to make sure that physicians are aligned with your hospital’s values and goals in practice, not just on paper. Health Leaders Media reported that encouraging physicians to take part in safety and and quality initiatives is one of the top three objectives behind physician alignment strategy. Aligning physicians with your hospital isn’t just about an agreement to coordinate services. It’s about providing a better standard of care at every level.

To make sure that your team is aligned in its mission, make sure that your goals and values are clear. Centers of excellence are constantly focused on performance improvement and never settle for the status quo. It’s wise to put effective communication strategies into place with feedback loops so that physicians can make informed decisions based on transparent data to give patients the highest quality of care.