During the 1990's I was one of the unfortunate hospital executives that experienced the challenges of integrating acquired physician practices firsthand.
When managed care began to take hold in the early '90s, many hospitals recognized that in order to maintain a competitive position in their communities they needed to have alignment with their primary care physicians. We thought, what better way to create alignment than to purchase physician practices? In a managed care model the specialty physicians were then controlled by the primary care physicians and were not acquisition targets.
We quickly learned that physicians often bring an entrepreneurial energy to their practice that immediately dissipates once employed by a hospital. We also learned that even though the primary care physicians were now "employed" they were no closer aligned to the hospital's goals than when they were independent. Shortly after acquiring these practices, hospitals either closed down or sold them off.
Given our experiences in the '90s, why are hospitals once again purchasing physician practices? This time both primary care and specialty practices? Hospitals are attempting to meet the demands of a value-based healthcare system, which requires a close alignment with physicians.
Having learned from past mistakes, a recently published article in Hospitals & Health Networks lists several goals for a successful hospital/physician integration model that truly manages the care of a population in a value-driven model.
- Unlike the attempts of the '90s, build a comprehensive network of both primary care and specialty physicians.
- Design a physician compensation model that provides bonuses for meeting clinical and quality measures.
- Develop measures that increase the quality of care, reduce unnecessary readmissions and improve the overall health of the population being managed.
- Allow the physicians to assume a true leadership role within the new organization.
- Make sure the hospital and physician groups are truly culturally aligned. The physicians should share the hospital's philosophy on patient centered care and population management.
- Hospitals should develop a reputation for being physician-friendly and collaborative.
Those of us in the device world are encountering more hospital/physician organizations everyday. By understanding the business philosophy of these organizations we can better position our corporate and product value propositions to align with their goals and philosophies.
Spend time with your clinical champions and ask them to outline the organizational structures, clinical philosophies, population management and readmission reduction strategies of their organizations. Make use of the information to fully engage key stakeholders within the hospital and forge long-lasting partnerships.
For comments or questions, contact Martin Gold at mgold@tapllc.com.
