4 Contemporary Issues in Hospital, Physician-Practice Integration

In a Feb. 12 webinar hosted by MedAxiom, Suzette Jaskie, president and CEO, and Joel Sauer, vice president of consulting, discussed trends in integration and the cardiovascular service line.

Mr. Sauer opened the webinar and spoke about the recent hospital/practice integration survey conducted by MedAxiom, the results of which were released on Jan. 10, 2013.  According to the survey, 50 percent of the 156 organizations that participated were fully integrated and another 10 percent were considering integration.

Ms. Jaskie then spoke about contemporary issues in integration. She outlined the following four issues.

1. Cultural integration. There are differences in leadership, decision-making and work styles between hospitals and physician practices, said Ms. Jaskie. Traditional hospitals, for example, tend to be more hierarchical and ordered, whereas traditional physician practices tend to be more entrepreneurial with a less formal work style. These differences cause a great deal of frustration for both organizations during the integration process and after. "This is a big hump to get over," said Ms. Jaskie. But organizations need to find a way to reconcile these differences to be able to move forward.

2. Renegotiation. This is a time when contracts are being renegotiated before they expire. It makes a lot of physicians nervous, said Ms. Jaskie. She suggests starting the renegotiation process early and developing a framework that has longevity. It is important for organizations to understand the playing field and to understand the value that was created through the term when entering renegotiation.

3. Redefining co-management. The co-management model must be developed early as it can fuel service-line development. For example, in some programs, co-management is a part of the compensation plan, where physicians are compensated for co-managing the service line. "This can fuel improvement with dollars," said Ms. Jaskie. There are a number of ways to define the model; however the financial impact of the initiatives is the most important measure of success.

4. Clinical councils. Clinical councils are the building blocks of the service line and are often the first to be set up when establishing a service line, said Ms. Jaskie. They drive everything from the scope of clinical care and program development to quality and performance metrics. They are typically organized around subspecialties or disease types. However, they need to become more consistent and defined. It is important to develop standards for them, she said.

According to Ms. Jaskie, organizations that are in the process of integrating or are considering integration need to be aware of these issues and formulate a plan to address them.

More Articles on Cardiovascular Service Lines:

Survey: 53% of Cardiologist Practices Are Integrated With Hospitals
The State of Hospital Service Lines: Current Challenges, Future Directions
Developments Influencing the Cardiovascular Service Line in 2013

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