High Performing Provider Networks: Do Your Hospital-Owned Medical Practices Measure Up?

    Posted by Lauri Miro on Mar 15, 2016 3:50:01 PM
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    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.

    Do we cultivate and promote skilled leadership?

    Too often health systems lack practice management expertise and attempt to run their practices from a hospital-centric orientation. The truth is that executive leadership for practice networks requires a unique skill set that can be hard to find. Leaders need to be strategic, with an ear to the ground and an eye on the future, and they must also understand practice-level operations in order to effect change.

    At the individual site level, hospitals often promote employees into management positions without considering their skills and training. Just because a staff member made an excellent customer service representative or medical assistant does not mean he or she is prepared to manage a practice effectively. This lack of skilled management leads to underdeveloped support staff, suboptimal provider productivity, and lower patient satisfaction. Without proficient site leadership, it is difficult to engage providers in shared governance.

    Network leadership and practice managers need excellent communication and organizational skills and must keep providers abreast of implications at both the practice and the broader health system level. The best network executives and practice managers promote a culture of accountability that endows every provider and staff member with a sense of ownership in their individual roles and in the success of the practice as a whole.

    Do we keep pace with evolving patient expectations and payment methodologies?

    Savvy patients and changing market dynamics are raising the bar for patient access and service. As retail clinics and urgent care centers continue to proliferate and compete for primary care patients, same-day visit access is becoming the expected standard of care. Value-based payment methodologies are challenging physician practices to enhance the quality and coordination of care while striving to meet core quality measures mandated by multiple stakeholders.

    Improvement in the health of populations requires a higher level of patient engagement than ever before. When patients are well informed, they can share in decision making and choose among the best healthcare options. With this in mind, it is becoming essential for practices to engage in patient care team meetings or other daily modes of communication where team members can review patients’ history and coordinate care. On a larger scale, practices can enhance the patient experience and improve outcomes by coordinating care among various providers and service points outside the primary care practice.

    High performing medical practice networks stay tuned in to the needs of patients and to the shifting expectations and requirements of the healthcare industry.

    Do we employ a viable physician compensation model?

    Many physician compensation models do not adequately incentivize physician productivity, service excellence, and clinical quality. System-owned practices often struggle with low physician productivity, which contributes to practice losses that are not sustainable. Many health systems deploy multiple compensation methodologies, ranging from cash collected to various formula-driven models, within a single physician network. This variation makes it difficult to manage practices with consistency, to convey a clear understanding of expectations, and to achieve unity among physicians. An ideal governance model allows physicians to examine various alternatives and adopt a consistent compensation model tailored for their market realities.

    Do we optimize our data and information exchange?

    Physicians who have been in private practice are accustomed to having detailed knowledge about their business operations. When they join a health system, many of their costs are varied or hidden, and they often don’t receive adequate information to help them manage their performance. Once an effective governance model begins to create accountability at the practice level, networks must have adequate tools to shape and manage the information they receive. Performance standards for productivity, revenue cycle, financial success, and optimal IT support should be tailored for both network and practice realities, with reporting that highlights relevant details for both individual practices and individual providers.

    A Challenging Future

    As we face rising patient expectations, increased competition, and evolving value-based payment methodologies, we will need to fully leverage the strengths of our practice operations while capitalizing on opportunities to improve. High performing networks will engage providers as partners through effective governance and timely dissemination of accurate, detailed data. The best performers will have skilled leadership in place both at the network and the practice level and will foster a culture that promotes accountability for excellence in service, quality, productivity, and financial viability.

    Does your physician network measure up when compared to best practices for operational and financial performance? Sign up for a complimentary 30-minute consultation to find out how Halley Consulting Group's network evaluation services can help you define a clear pathway for performance improvement.


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    Topics: Operational Governance, Engaging Employed Physicians, Network Evaluation

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