Physician alignment, referral leakage and more — 4 experts discuss financial strategies for a value-based world

For hospitals and health systems in the midst of transitioning from fee-for-service to value-based care, new financial and alignment strategies are crucial to success.

A group of panelists recently discussed their organization's strategies during the Becker's Hospital Review 9th Annual Meeting April 11. Panelists were Stonish Pierce, system vice president of specialty services at Southfield, Mich.-based Beaumont Health; Jeff McHugh, senior vice president of enterprise solutions at Zotec Partners, a revenue cycle management and practice management solutions provider; Cindy Bo, chief strategy and business development officer of Jacksonville, Fla.-based Nemours Children's Health System; and Karen Testman, RN, CFO of Fountain Valley, Calif.-based MemorialCare Health System.

Here are three takeaways from the discussion.

1. Investment in outpatient care. Amid the transition to value-based care, MemorialCare Health System has placed an emphasis on population health and employed an ambulatory strategy. In January, the organization's joint venture with RadNet launched, creating southern California's largest imaging network with 34 outpatient medical imaging centers. Patients "want to be treated in lower-cost setting closer to home. We believe that's key to population health going forward, [and] we've really invested in that being the future," Ms. Testman said.

2. Physician alignment. At Beaumont Health, market consolidation has played a role in physician alignment. In 2014, three Michigan health systems — Beaumont Health System, Oakwood Healthcare and Botsford Health Care — came together to create Beaumont Health. Mr. Pierce said he believes Beaumont's brand reputation, strong financial performance and geographic scope resulting from the merger has made the system attractive to new and established physicians.

Nemours' physician alignment strategy emphasizes partnerships with adult health systems. Since Nemours is a freestanding pediatric health system offering quaternary/tertiary care, Ms. Bo said highlighted importance of Nemours aligning with physicians in those adult systems to coordinate care for patients that may require Nemours' specialty services.

"From primary care (medical home) to medical/surgical services to the ED, our physicians work as an integrated care team with other providers to ensure our patients are receiving the best care and optimal experience," said Ms. Bo. "One of the other strategies is to ensure that Nemours is part of narrow networks created by providers and/or payers. These narrow networks allow Nemours to be the preferred pediatric provider of choice for a sub-population (e.g., associates of the adult systems and their dependents)."

3. Driving down costs though physician alignment. For hospitals looking to drive down costs through physician alignment, data plays a key role as it can identify patient referral leakage, according to Mr. McHugh. He says there are tools to help with that, and "it's about finding the tool that has the data to give." He added: "There's value in patient loyalty and technology."


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