The traditional hospitalist group will have to invest in new infrastructure, staff and care models to take adapt to the shift in healthcare toward value-based care, according to a whitepaper titled "The Hospitalist Group Model for Value-Based Care," released by Wyatt Matas, a healthcare investment banking firm.
According to the Society of Hospital Medicine, hospitalists are physician and non-physician providers who provide medical care for acutely ill patients in a hospital setting. They are generally trained in internal medicine, general pediatrics or family medicine. They are typically contracted by hospitals and physician groups.
Hospitals and physician groups that have entered into value-based contracts are holding hospitalist groups accountable for the costs and outcomes they can control.
To remain competitive in an increasingly value-based care environment, hospitalist groups will have to invest in their infrastructure and create innovative care models to play a more active role in the patient's care cycle.
The whitepaper outlines the core infrastructure investments that hospitalist groups should make to remain competitive:
1. Hospitalist groups should experiment with different care delivery models, and they should utilize physician extenders, such as nurse practitioners and physician assistants. Some groups are also investing in care managers who support the hospitalist and patient at the time of discharge.
2. Hospitalist groups should invest in practice management technology that enhances communication among providers, improves management of the revenue cycle and promotes seamless transitions of care.
3. Hospitalist groups should invest in post-discharge management services to follow up with patients just before and after discharge.
4. An experienced and passionate management team is essential for the success of a hospitalist group. With hospital contracts becoming increasingly complicated, hospitalists groups need management teams who understand the nuances of value-based care.
The white paper also outlines some of the innovative care models that hospitalist groups have created to meet the demands of being a valued partner to accountable care organizations, which are heralded by some as a cornerstone example of a value-based care model:
• A Southwest hospitalist group has begun to employ "transitionalists," such as nurse practitioners, who see patients just before discharge and then follow them for 30 days after they leave the hospital. This addresses potential transitions of care issues.
• A Mid-Atlantic hospitalist group began offering their hospital partners "triage-ists" who are stationed in the emergency departments with the goal of preventing avoidable hospital readmissions.
• A Mid-Western hospitalist group is deploying a comprehensive transitional care model that includes embedded care managers working with hospitalists at the hospital, a clinical call center to support patient follow up post-discharge and "SNF-ists" to care for patients in skilled nursing facilities.
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