Physician Alignment Strategies For Health Systems
The American healthcare system is, to put it mildly, complex. As health systems shift their focus from volume to value, a growing number of physician practices are consolidating and more individual physicians are joining health systems. A 2016 American Medical Association’s (AMA’s) Physician Practice Benchmark Surveys study found that only 47.1 percent of physicians in 2016 had ownership stakes in medical practice, down from 53.2 percent in 2012. The AMA survey collected information on four aspects of physician practice arrangements: 1) whether physicians are owners, employees or independent contractors with their main practice; 2) the type of practice that they work in; 3) the ownership structure of their main practice; and 4) the number of physicians in their main practice (practice size).
Transitioning Physicians to Value-Based Payment Models
As health systems seek to forge an integrated, high-value network, an assessment of current resources and clinical capabilities is necessary. With the rapid move away from volume-driven health care, health systems now need physicians to share their new goal of decreasing utilization. Referring back to the AMA’s survey, many physicians are now affiliating with a larger organization that can help reduce financial and regulatory risk and provide a full spectrum of resources for all clinical and nonclinical activities. A 2016 survey from the Deloitte Center for Health Solutions (DCHS), an organization that looks deeper at the biggest industry issues and provides new thinking around complex challenges, suggests that physicians prefer the status quo and that participating in value-based payment models is still fairly unusual. Most physicians are not interested in participating in value-based payment models without additional incentives or capabilities. The Deloitte survey notes that 58 percent of physicians expect increased physician consolidation and that independent physicians prefer joining clinical networks rather than being employed.
In today’s healthcare environment, clinicians typically make decisions based on data they collect in clinical care settings. This data creates a snapshot of the patient’s health at single points in time, rather than continuous measurements outside of clinical settings. While health systems have implemented many steps in order to achieve better physician alignment, embracing these values can be a challenging cultural change. While we ultimately will discuss all six strategies, this article will cover three and the next article will cover the remaining three. These strategies have been identified to help health systems and physicians achieve better alignment and meet their value-based care goals. These strategies are from a Deloitte Center for Health Solutions (DCHS) report.
Successful Value-Based Models Requires Digital Health Services
Transitioning to a more digital health delivery model may require new departments and create new positions that focus exclusively on the digital health experience (i.e. Digital Strategy Transformation Director, Digital Health Experience Director). Those that lead a system-wide digital health initiative will develop and implement a strategic roadmap for the development of all digital health capabilities, which will likely include external partners and/or vendors. The first strategy, know your partners, requires the responsibility of the health system to know their partners and explicitly set the expectations. A range of multipronged alignment models exists today so, for the most part, there’s no need for a health system to create a model from scratch. The figure below is an example of a few multipronged, flexible alignment options.
A Physician-led structure
As more physicians continue to affiliate themselves with health systems, it is a mistake for these organizations to treat physicians as employees or contractors. Health systems should create a strategy that values open communication and continuous feedback. Many systems develop and implement a strategy to engage physicians by giving them the authority to drive change by setting up a committee to plan and implement strategic initiatives. Simply put a physician-led structure is the most effective.
Support data-driven decisions
Industry disruptions and technology innovations have prompted health systems to rethink and transform their operations through flexible, more connected digital solutions. The solutions successful health systems look for in technology platforms must be secure, easy to use, integrated, and fast to deliver. A 2016 Deloitte Survey of US Physicians shows that 35 percent of physicians do not receive any care pattern information, and 16 percent utilize data in making referrals. In contrast, 90 percent of the physicians responded that they consider care pattern information to be useful. The survey also shows that physicians believe that electronic health records (EHRs) are most useful for analytics and reporting capabilities. However, EHRs must improve workflow and increase productivity through meaningful and actionable information by identifying relevant data points and metrics. The survey also shows that physicians want interoperability and that would most likely improve patient outcomes.
With so much more healthcare data being digitized today, it’s easy to understand how health systems can spend more time locating, gathering, and scrubbing data than they do analyze it.