Pursuing Medical Practice Success: The Big Picture

    Posted by Katrina Slavey and Dale Gentz on Apr 24, 2018 11:16:00 AM
    Part of the Pursuing Medical Practice Success series:
    1. An Hour a Month Could Save You Many Sleepless Nights
    2. The Practice Manager as Change Agent
    3. The Heartbeat of Your Practice
    4. The Building Blocks for High Performance
    5. The Big Picture


    The first four parts of our Pursuing Medical Practice Success series have focused on practice operations. Do the lessons learned so far also apply to a medical group or network and not just to an individual practice? Yes, they do. Here’s how:

    Like individual medical practices, high performing medical groups and provider networks engage their providers in the operational governance of their group. We use the expression “physician led, professionally managed” to reflect the important role providers must play in achieving organizational success.

    At the medical practice level, the practice manager and all providers meet together in a Practice Operations Council (POC). The same principles apply at the medical group level, but instead of a POC, stakeholders establish what we refer to as a Network Operations Council (NOC). Membership in the NOC is made up of senior-level leadership—usually the network executive and one or two additional leaders such as the CEO (market manager) and the CFO—and select physicians who are actively practicing within the network. Not every practice is represented, but every specialty usually has a seat at the table. Membership is based on the providers’ leadership qualities and is not a representative form of governance. The network executive and/or the market manager selects a provider to serve as the chairperson of the NOC. Members are then invited to participate by the network executive, in consultation with the chairperson. They usually serve staggered terms, which prevents the loss of accumulated knowledge while still bringing fresh perspectives to the group regularly.

    Topics addressed in the NOC focus on strategic initiatives of the medical group and differ from those operational challenges discussed by POCs. For example, the NOC might discuss any of the following matters:

    • network-wide policies
    • medical staff development
    • network and practice performance
    • quality initiatives
    • trends impacting the network, such as a shift from volume-based medicine to value-based
    • provider compensation models
    • provider productivity
    • patient satisfaction
    • provider engagement
    • referral management
    • network executive accountability

    Just as the POC develops a site-specific action plan (SSAP), the NOC develops a quarterly action plan (QAP), which the network executive is accountable to implement. Like the SSAP, the QAP serves as a focal point for the work of the NOC and as the basis for its monthly agenda. Meetings are limited to two hours and usually take place at the end of the business day.

    With the above background in mind, it is important to discuss what the NOC is not. Unlike a board of directors or trustees, the NOC does not have fiduciary responsibility. Its authority is delegated by the market manager or the board itself. Authority in the council model is intended to engage physicians as active, collaborative partners with management leadership in setting strategic direction, establishing policies that affect their ability to deliver quality care, and holding their peers accountable for performance and behavior. Network Operations Council meetings provide the opportunity to discuss and implement tactics regarding integrated care models such as population health management. The NOC determines how the medical group works best with the parent organization, creating a win/win situation for all.

    As we have discussed throughout this series, the foundation for medical practice success begins with spending one hour per month in a Practice Operations Council, ensuring you have hired a practice manager who is truly an implementer, and utilizing a site-specific action plan as your tool for driving change. Implementing the Network Operations Council ensures that all practices are integrated and fully functioning within the parent organization.


    Implementing an operational governance model successfully can be complex—and describing the process in depth is beyond the scope of this blog post. If your organization recognizes the value of engaging your providers actively in a collaborative decision-making process, we can help. Call us at 614-899-7325, or click here to schedule a complimentary consultation.



    Topics: Operational Governance, Engaging Employed Physicians

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