With the evolution from volume-based to value-based care, healthcare organizations have been viewing the service experience through a new lens—one that puts the patient at the center of the universe and calls for a more coordinated, integrated approach to care. As a result, many hospitals and health systems are taking a closer look at physician integration strategies that can help them grow market share while providing high-quality services at lower cost across the healthcare continuum.
Implementing an effective operational governance model is a galvanizing first step on the pathway to developing a high performing physician network. Once this model is in place and physicians are taking an active role in the governance process, it is time to take a closer look at your medical practice network’s level of operational performance.
Below we’ll examine four key questions that can help your physician and executive leaders gain valuable insight into how your physician network measures up to a high performance standard in today’s demanding healthcare environment.
This post originally appeared on the MedCity News website on December 6, 2015.
On a recent assignment, we encountered a hospital client who had built up a bureaucratic maze of medical directors and executives tasked with steering both the business and clinical sides of the hospital’s owned medical practice network. Unfortunately, rather than facilitating smooth operations, the additional layers of management slowed the decision-making process, created confusion for providers and support staff, and produced inconsistent operating performance from clinic to clinic.
At the client’s request, we provided training on operational governance and introduced our council model to the physician network. As they began to implement our training, the physicians and other providers became engaged as peers and as partners, providing the positive peer pressure and clinical direction necessary for day-to-day operations within each individual practice and across the entire medical group.
In implementing this new system of operational governance, our hospital client noted that many of their traditional medical director roles had become superfluous. As a consequence, they asked for our help in creating a streamlined and effective implementation management infrastructure that would support the new operational governance model and perhaps even allow for the elimination of these unnecessary director roles.
Such a request is not uncommon; we have interim managers out in the field who are seeing similar situations on a regular basis. What we’ve learned from being on the ground is that, as we mentioned in the previous article, hospital-owned physician networks can benefit greatly from studying successful independent practices and applying what they learn to their own infrastructure.
Let’s take a look at some of the principles of management that work well for independent practices and examine how those principles can apply in a medical practice network setting.
In Part I of our post on engaging employed physicians in your hospital's success, we discussed engaging with physicians as business partners. In this post, we explore a successful model for decision-making, performance improvement and accountability.
A few years ago, a client engaged us to conduct an evaluation of their multi-specialty, multi-site group practice, which was organized as an integrated component of a local health system. This multi-site network suffered from high physician turnover and annual financial losses in the millions. As we began to delve into the everyday workings of the practices, we found that the physician CEO who managed this network had an autocratic leadership style, and the providers had little input into decisions that affected their daily lives. The practice management team gave inadequate attention to clinical or service quality. Performance expectations were unclear. Provider productivity varied dramatically, and no one was held accountable for performance improvement. As a consequence, the individual providers felt no concern for practice or enterprise performance.
We’d seen this scenario many times, and we quickly zeroed in on the fact that the providers’ indifference to the success of the organization was hindering performance improvement for the entire network.