The Dynamics of Physician Alignment

The Dynamics of Physician Alignment


With the changing pressures brought on by the Patient Protection and Affordable Care Act and the inevitable reimbursement reductions, health systems continue to maximize efforts to grow physician networks to preserve their patient base.

The 2013 HealthLeaders Media Physician-Hospital Alignment Survey reveals that a staggering 87% of respondents anticipate an increase in their organization's employed physician base within the next 36 months. At the same time, 70% of respondents anticipate their organization's number of independent physicians to decrease over the next three years.

It's no surprise that physician engagement ranked highest as the most difficult aspect of managing physicians. We have learned that finding the right compensation model is important to building strong physician relationships, but it's only a starting point. True alignment requires an enhanced focus on engaging physicians. We feel it's time to embrace interdependence and come to an agreement on what that means for both parties. It's certainly possible and the health systems who can achieve this will stand above the rest. But more importantly, their patients win.

J.R. Thomas
CEO, MedSynergies

The 2013 Physician-Hospital Alignment Survey, an independent HealthLeaders survey sponsored by Medsynergies and conducted by the HealthLeaders Media Intelligence Unit, demonstrated that healthcare organizations are recasting their priorities to meet the expected requirements of industry reform. And, as the annual survey reveals, not only are there changes in emphasis regarding employment models, but also increased pursuit of collaborative relationships and at-risk payment models. The full version of this report, provided courtesy of MedSynergies, Inc., contains a detailed overview of the report results. A brief registration is required.

From Commodity to Value-Added Partner

Increased Emphasis on Physician Alignment and Collaboration

Partnership in a Competitive Environment

Taking the Physician Alignment Initiative

From Commodity to Value-Added Partner

Alignment discussions are taking on a flavor of collaboration or mutual accountability, fostered by doubts on the part of many in acute care settings about whether the fee-for-service business model is sustainable. "Physicians are trying to understand how they go from being just a commodity and become a value-added partner," says T. Clifford Deveny, MD, senior vice president of physician services and clinical integration for Catholic Health Initiatives. 

Near-term shifts in organization models indicate that hospitals and health systems will place more emphasis on collaboration. One-fifth of respondents (22%) include clinical integration among their top three staffing models now, but three years out, twice as many, or 46%, expect to be involved in clinical integration. "We're going to be doing more partnering with physicians rather than employing or just underwriting them," Deveny says. "It will be a shared-risk or pay-for-performance structure. We're going to come together, share data, and present ourselves as a network. Collectively, we will either all succeed or fail. "On-staff physicians will have to be more collaborative as well. Clinical co-management agreements stand at 15% now, and respondents say that will increase to 30% in the three-year time frame. 

 


 Back to Top

 Increased Emphasis on Physician Alignment and Collaboration

Survey results show expected increases in employed physicians and decreases in independents. The average percent increase in employed physicians in the three-year time frame is 40%. Over the same time period, the average percent decrease in independent physicians is expected to be 29%. But with the average number of employed physicians standing at 246 per respondent compared to 693 per respondent in independents, the latter will be in the majority three years hence, despite the expected decrease. "I've doubled the number of employed physicians" says Pamela Stoyanoff, executive vice president and chief operation officer at Methodist Health System.

 
Back to Top

Partnership in a Competitive Environment

Even though it is more common, still, for both parties to approach the alignment topic with income preservation in mind, larger groups with financial stability may provide an early view of what is to come in a more competitive environment. "There's been a lot of discussion around income preservation and keeping physicians happy," Deveny observes, "but mature physicians are saying, 'We're financially sustainable. We know where we're going. We're looking for a partner, a hospital system partner.' That tends to be a better discussion."

                                                                                                                                                                                                                                                   

Back to Top

 Taking the Physician Alignment Initiative

When respondents talk about current and near-term initiatives, the talk is about collaboration and risk-sharing. Today, 41% of respondents are involved in an ACO, up from 26% in last year's survey. Within three years, 55% will be pursuing or involved in an ACO. 

Other collaborative care models are gaining traction, according to survey respondents. More than half of respondents (52%) are now undertaking initiatives related to a patient-centered medical home, up from 39% a year ago, and 58% expect to be there within three years. Similar growth is seen for the population health model, which was a current initiative of just 25% last year, now stands at 33% of respondents, and will reach 51% within three years.
 

 
Back to Top