Strategic Physician Solutions - Physician Advisory Council

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Information about Strategic Physician Solutions - Physician Advisory Council
Health & Medicine

Published on March 10, 2014

Author: CoorsHealthcareSolutions

Source: slideshare.net

STRATEGIC PHYSICIAN SOLUTIONS™ Coors Healthcare Solutions Coors Healthcare Solutions © 2013 1

Challenges • [Physician satisfaction scores] • [Physician retention] • [Profitability of physician practices] • [Physician recruitment ] • [High use/costs of Locums] 2Coors Healthcare Solutions © 2013

Program Objectives • Physician Advisory Council (PAC)™ to develop foundation of communication between administration and physicians • Develop alignment options (MSO, Co-management, etc.) • Physician recruitment and retention training through Coors Right Hire™ 3Coors Healthcare Solutions © 2013

Organizational Strategy Needs Assessment / Gap Analysis Physician Strategy Physician Alignment Contracts, Compensation & Implementation Physician Recruitment & Retention Physician Integration Strategic Physician Solutions™ Coors Healthcare Solutions © 2013 4

DATA SUPPORTING THE NEED FOR INCREASED PHYSICIAN ALIGNMENT Coors Healthcare Solutions © 2013 5

Alignment Drivers – National Perspective • Physician Drivers: – Reimbursement – Health Reform – Administrative Complexity – Recruitment – Concern for Future Referrals • Hospital Drivers: – Clinical Integration – Health Reform – Fear of Market Share Loss – Competition – Hospital Based Reimbursement 6Coors Healthcare Solutions © 2013

0 10 20 30 40 50 60 70 80 Orthopaedics General Surgery Cardiology Hospitalists Primary Care Hospitals With MD Employment Plans: Top 5 Areas Over Next 3 Years 7 Healthcare Integration Trend Source: HealthLeaders “Physician Alignment in an Era of Change” September 2010 Coors Healthcare Solutions © 2013

8 Healthcare Integration Trend Source: MGMA Connexion “Medical Practice Today” July 2011 Coors Healthcare Solutions © 2013

Top Considerations For Doctors • Alignment of Model Options • Health System Motivations • Referral Sources • Financial • Governance, Term and Exit Strategy • Health Care Reform 9Coors Healthcare Solutions © 2013

WORRY MOST CONCERNING SOMEWHAT CONCERNING LEAST CONCERNING 2011 2008 2011 2008 2011 2008 Availability of Free Time 48% 33% 45% 46% 7% 22% Dealing with Payors 42% 13% 45% 44% 13% 43% Earning a Good Income 41% 38% 47% 45% 12% 18% Malpractice 40% 32% 44% 37% 16% 31% Health System Reform 39% N/A 47% N/A 14% N/A Educational Debt 30% 60% 36% 14% 34% 27% Ability to Find a Practice 24% 41% 34% 38% 42% 21% Insufficient Practice Management Knowledge 22% 4% 57% 47% 21% 49% Insufficient Medical Knowledge 7% 30% 25% 24% 68% 46% Dealing with Patients 2% 4% 15% 35% 83% 42% 10 What Worries First-time Doctors Source: 2011 Survey of Final-Year Medical Residents, Merritt Hawkins & Associates, Oct. 5 Coors Healthcare Solutions © 2013

MUST-HAVE MOST IMPORTANT SOMEWHAT IMPORTANT LEAST IMPORTANT 2011 2008 2011 2008 2011 2008 Geographic Location 81% 57% 19% 12% 0% 31% Adequate Call/Coverage/Personal Time 68% 28% 31% 53% 1% 19% Lifestyle 64% N/A 34% N/A 2% N/A Good Financial Package 56% 46% 42% 41% 2% 13% Proximity to Family 52% 30% 35% 37% 13% 33% Good Medical Facilities/Equipment 44% 23% 51% 43% 5% 34% Specialty Support 31% 17% 54% 51% 15% 32% Low Malpractice Area 16% 33% 58% 31% 26% 36% Education Loan Forgiveness 12% 42% 38% 24% 50% 34% 11 Location Tops List Of Must-haves Source: 2011 Survey of Final-Year Medical Residents, Merritt Hawkins & Associates, Oct. 5 Coors Healthcare Solutions © 2013

COMMUNITY POPULATION 2011 2001 10,000 or less <1% 0% 10,001 – 25,000 4% 8% 25,001 – 50,000 2% 13% 50,001 – 100,000 10% 21% 100,001 – 250,000 15% 15% 250,001 – 500,000 21% 25% 500,001 – 1 million 20% 12% More than 1 million 28% 6% 12 More Prefer Major Metro Areas Source: 2011 Survey of Final-Year Medical Residents, Merritt Hawkins & Associates, Oct. 5 Coors Healthcare Solutions © 2013

Physician Alignment: Due Diligence / Required Evidence • Financial Performance • Key Financial and Operating Indicators • Care Statistics • Quality Indicators • Compliance • Coding Compliance program • Character • Personal History • Succession Planning • Ages/Demographic Group • Malpractice Record • Past/Current Malpractice Action • Tail Coverage • Physician Office • Location • Operational Issues • Quality and Productivity • Mission/Patient Service • Physician Compensation and Productivity Analysis 13Coors Healthcare Solutions © 2013

PHYSICIAN ALIGNMENT TOOLS Featuring the PAC™ Coors Healthcare Solutions © 2013 14

Physician Alignment Goals 1. Development of Physician Advisory Council (PAC)™ 2. Engage Medical Staff 3. Physician/Hospital Alignment Options Coors Healthcare Solutions © 2012Coors Healthcare Solutions © 2013 15

Physician Engagement 16Coors Healthcare Solutions © 2013 • Getting Physicians’ Participation • Getting Physicians’ Attention • Getting Physicians’ Commitment

Physician Engagement – Built Not Bought 17Coors Healthcare Solutions © 2013

Goal 1: Physician Advisory Council (PAC)™ • Implementation of full program • Creating a partnership between hospital administration and medical staff • Increasing communication and promoting transparency to build trust 18Coors Healthcare Solutions © 2013

PAC™ Philosophy • Physicians are a hospital's number #1 customer! • This philosophy is the foundation to create a Physician-centric customer service model Coors Healthcare Solutions © 2012 19

PAC™ Design • TRANSPARENT COMMUNICATION – Open atmosphere • SEAT AT THE TABLE – Physician and decision makers • DIRECT INPUT TO CEO - Input for decisions effecting physicians and patient care • OPEN FORUM – Early discussion with Physicians – avoiding crisis • ALIGNMENT with Strategic Needs – Physician alignment with Organization’s strategic needs Coors Healthcare Solutions © 2012 20

Benefits of the PAC™ • PAC™ members create a who’s who buzz among the medical community • Informal dialogue between P.A.C. members and the medical community circulates fresh feedback, ideas, issues or concerns • Monthly meeting notes create tangible evidence of progress on known issues and circulates positive feedback • Overall improved physician satisfaction and relationships Coors Healthcare Solutions © 2012 21

PAC™ Structure Board P.A.C.™Administration Medical Staff Communication Coors Healthcare Solutions © 2013 22

• Successfully aligns current physicians with the strategic needs of the organization • Establishes the groundwork for the assimilation of new physicians coming into the organization • The PAC™ is not designed to assume or disrupt any functions of the MEC or other committees of the medical staff such as: – Peer Review – Credentialing – Quality assurance/CQI functions – Writing changes in bylaws • PAC™ strategically aligns and strengthens the existing medical community PAC™ - An Alignment Tool Coors Healthcare Solutions © 2012 23

PAC™ Wins! Mercy Hospital Mt. Airy 2006 – Physician Perception of “Excellence” Percentile Rankings 2010 – Physician Perception of “Excellence” Percentile Rankings Coors Healthcare Solutions © 2013 24

PAC™ Wins! Northwest Medical Center • Developed a strategic Master Plan that ensured "vested constituencies" • Developed a 5 year Physician recruitment plan (successfully recruited 23 physicians with one year) • Increased Patient satisfaction from 4th quartile to 1st quartile and maintained that quartile for years until company was sold • Increased admissions by 14% Open Heart Surgeries 72% O/P Surgeries 30% Cardiac Cath 58% 25Coors Healthcare Solutions © 2013

PAC™ Wins! Gateway Regional Medical Center • Developed a 5 year Master plan that charted the hospitals course for becoming Surgical and cardiac based hospital verses Psychiatric • Grew cardiac business 60% in 2012 opening hospital's first cardiac cath lab in 2011 • Established robotic surgery program (daVinci) First year did over 140 robotic surgeries • Increased Physician satisfaction from 34% very satisfied in 2011 to 54% very satisfied in 2012 • Developed a Geriatric Hospitalist program decreased readmissions by 20% in 4 months • Successfully recruited 22 physicians as part of the succession plan without cannibalizing existing medical staff. 26Coors Healthcare Solutions © 2013

Goal 2: Engage Medical Staff • Engage medical staff to increase physician satisfaction & communication • Set attainable goals for physician satisfaction scores based on national averages / best practices • Create a positive medical staff environment • Increase quality patient outcomes 27Coors Healthcare Solutions © 2013

Building Physician Engagement Five questions to build more powerful physician engagement: 1. What do you want your physicians to do? Physicians will be more highly engaged when they are actively included on the substantive issues 2. Do they know how to do the work? Physicians are problem solvers on steroids 3. Do they have the resources to do the work? CEOs must demonstrate that leadership and strategic work are legitimate and important parts of physicians’ jobs 4. Are physicians motivated to do the work? Many capable physicians avoid taking on the leadership work 5. How will CEOs know they have been effective? Being clear about the positive impact of better physician engagement in the change process is a critical step in shaping the message to physicians 28Coors Healthcare Solutions © 2013

Goal 3: Alignment Options Employment Business Services Contracts  Physician Compensation/ Productivity Models  Single-Specialty Group  Multi-Specialty Group  Physician Network Development  Management Services Organization (MSO)  Practice Leasing / Enterprise Model  Lease / Real Estate Contracts  I.T. Infrastructure  Payor Contracting Organizations  Clinical Integration / Physician Networks  Physician Recruitment  Call pay arrangements  Medical Directorships  Clinical Co- management Arrangements  Professional Services Agreements  Joint Ventures  Practice Leasing 29Coors Healthcare Solutions © 2013

Blueprint For MSO Development • Business Development – Central Business Office (CBO) – Clinical Services • Physician Development – Practice Management – Practice Operations – Regulatory and Compliance • Contract Management • Data Management – Facilities Management – Financial Management – Human Resources – It Support – Marketing Coors Healthcare Solutions © 2013 30

• Benefits of this arrangement: – Hospital agrees to operate the practice at a fixed percentage of collections; both parties incentivized to produce results – No capital expenditures required – Hospital benefits from stronger alignment with physicians in a less formal manner than employment – Physicians preserve the private practice model and autonomy – Physicians can achieve balance of security and independence – Should the venture become unsatisfactory or unsuccessful, the arrangement is much easier to unwind than a practice acquisition 31 The Physician Enterprise Model: A Non-Employment Alternative Coors Healthcare Solutions © 2013

The Physician Enterprise Model: A Non-Employment Alternative Illustration: 32Coors Healthcare Solutions © 2013

Clinical Co-Management • Service line partnerships between hospitals and physicians • Align hospital / physician incentives to achieve improved patient outcomes with greater efficiency and lower costs • Allows hospital flexibility to utilize employed or independent physician groups • Typical co-management service lines: Cardiology, Orthopedics, General Surgical 33Coors Healthcare Solutions © 2013

 Licensing Arrangements  Coding Compliance Program  Revenue Cycle Management  Billing/Collections Services  Practice Compliance and Integrity Programs  Physician Practice Start-Up Services  Comprehensive Physician Practice Assessment/Business Plan  Medical Practice Valuation  Standardized Policy/Procedure Development  Educational Programs  Quality Standards/Benchmarking  Fair Market Value Opinion Letters  Physician Contract Compliance Program  Interim Management  Advisory Management Services  Management Mentoring Program Value Added Physician Services

Med Auxilium™ Physician Recruitment & Retention A BLUEPRINT FOR SUCCESSFUL PHYSICIAN RECRUITMENT Coors Healthcare Solutions © 2013 35

Get Your House In Order: Build Your Foundation 36Coors Healthcare Solutions © 2013 Organizational Strategy Community Need Analysis Proof: Support for Road Map Needs Assess / GAP Prioritize goals Practice Viability & Due Diligence Develop Road Map Physician Strategy PAC™ Engage Medical Staff Transparency = Trust Alignment Structure Options Physician Alignment Standardized Contracts Performance Incentives Create Compensation Equality Contracts & Compen- sation Coors Med Auxilium™ Physician Recruitment & Retention Training

Med Auxilium™ Program Goals Robust turn-key approach brings the physician recruitment process in-house: • Assessment of existing recruitment practices and department • Sets Standardized Process • Develops strong communication skills • Developing relationships and tools – Cure for the Chaos to create a funnel for Residents / Fellows • Development of recruitment strategy – goals, process, performance measures • Full 12-month training and mentoring of recruitment team and leadership for effective implementation • Determine practice setup and on-boarding • Retention strategies for continued success 37Coors Healthcare Solutions © 2013

Med Auxilium™ Program With Toolbox • Customized based on organizational strategy, goals, existing structure and scope 38Coors Healthcare Solutions © 2013

Physician Integration End Goal of Full System Coors Healthcare Solutions © 2013 39

• Manage employed physicians – Operations improvement – Coding compliance program – Revenue cycle management – Practice compliance & integrity programs – Develop Primary Care feeder programs • Involve physicians in measuring quality goals • Clinical Integration, Co-Management, IT infrastructure Physician Integration Coors Healthcare Solutions © 2013 40

STRATEGIC PROGRAM IMPLEMENTATION Targeted Goals Coors Healthcare Solutions © 2013 41

Proposed Action Plan • Review Needs Assessment • Implement PAC™ • Interview Medical Staff • Review Alignment Best Options • Med Auxilium™ Program Implementation 42Coors Healthcare Solutions © 2013

www.CoorsHealthcareSolutions.com 1.800.507.6917 43

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