There is growing interest in co-management arrangements, as they are a means to involve a large group of medical staff members in processes to promote evidence-based medicine, coordination of care, outcome measurement and reporting, operational efficiencies and other organizational improvement efforts. The traditional medical staff model has been somewhat effective in these areas — thanks to the leadership of some physicians — but it often fails to achieve the desired level of commitment from a broad base of physicians.
Co-management arrangements are seen as a way to change this, at least in very specific clinical areas. Co-management arrangements are a stepping stone to more expansive relationships, without resorting to physician employment, practice acquisition or other such intrusive endeavors. They permit a hospital and physicians to work through issues on a small-scale, learning and perfecting a model that can serve as a template for an accountable care organization (“ACO”) or as the foundation for a bundled payment arrangement.
There are many issues associated with setting up a co-management structure, including identifying duties and responsibilities for governance, management and decision making, as well as establishing performance standards and reasonable compensation for services.
Decisions must be made as to eligibility standards for physician participation and on the co-management entity’s corporate structure. The diagram below illustrates the six major steps involved in the formation of a co-management arrangement.
Outside, objective expertise and facilitation will aid in proactively identifying relevant issues, help the parties work through them, and speed-up the formation process.
For more information on designing and implementing co-management arrangements, please contact Steve Nahm or Jennifer Lee at 310-320-3990 or snahm@thecamdengroup.com or jlee@thecamdengroup.com.
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