At the Becker's Hospital Review 4th Annual Meeting in Chicago on May 11, Stephen Kardon, principal at North Highland, walked through six imperatives hospitals and health systems must consider when forming a clinical enterprise.
"The future is really focused on episodes of care," Mr. Kardon said. Many hospitals or systems are beginning to focus on profitable service lines, such as cardiovascular health and orthopedics, and get out of service lines that do not make as much money, according to Mr. Kardon. A clinical enterprise, he explained, is an organization focused on the triple aim for a discrete population of patients or an episode of care, such as orthopedics.
The following are six things organizations must focus on when building out a clinical enterprise for an episode of care.
1. Physician-hospital alignment. The first thing hospitals need to look at is how they are aligned with physicians. Mr. Kardon stressed that the proper alignment doesn't always mean employment, the alignment strategy just needs to drive patients into the network. One of the best things to look at is referral patterns. "Most hospitals have no earthly idea what their referral patterns look like," Mr. Kardon explained. "They don't know how is driving the business."
Employment may work, but Mr. Kardon had the following warning: "Physicians that are wildly successful don't want to become employees," he said. "But you want the 'A' players on your team."
2. Marketing. Marketing a clinical enterprise can be difficult, Mr. Kardon said, because some physician groups will want their name specifically marketed, while most hospitals would like their name to be prominent in marketing materials. "You have to come up with right answer and have the doctors sit in the room," Mr. Kardon said, so the physicians will support the marketing strategy.
3. Distinctive clinical programs. To have a true clinical enterprise, it must be a world class program. A world class program provides high quality care, coordination, technology, patient education and patient experience, according to Mr. Kardon.
4. Operations and facilities. For a successful clinical enterprise, Mr. Kardon said that hospitals should allow the physicians to govern the operations and facilities while providing a limited amount of oversight.
5. Primary care physicians. Hospitals must look at how they manage and work with primary care physicians in the market. "The goal is to align the primary care physicians with the specialists," said Mr. Kardon.
6. Financials. It is important for the hospital to start to discover the contribution margin and profit by modality and specialty. "We really don't know what things cost," Mr. Kardon said, but it is important to figure out, because patients are going to start shopping around by price. It is also important to find out competitor's rates, he said.
"The future is really focused on episodes of care," Mr. Kardon said. Many hospitals or systems are beginning to focus on profitable service lines, such as cardiovascular health and orthopedics, and get out of service lines that do not make as much money, according to Mr. Kardon. A clinical enterprise, he explained, is an organization focused on the triple aim for a discrete population of patients or an episode of care, such as orthopedics.
The following are six things organizations must focus on when building out a clinical enterprise for an episode of care.
1. Physician-hospital alignment. The first thing hospitals need to look at is how they are aligned with physicians. Mr. Kardon stressed that the proper alignment doesn't always mean employment, the alignment strategy just needs to drive patients into the network. One of the best things to look at is referral patterns. "Most hospitals have no earthly idea what their referral patterns look like," Mr. Kardon explained. "They don't know how is driving the business."
Employment may work, but Mr. Kardon had the following warning: "Physicians that are wildly successful don't want to become employees," he said. "But you want the 'A' players on your team."
2. Marketing. Marketing a clinical enterprise can be difficult, Mr. Kardon said, because some physician groups will want their name specifically marketed, while most hospitals would like their name to be prominent in marketing materials. "You have to come up with right answer and have the doctors sit in the room," Mr. Kardon said, so the physicians will support the marketing strategy.
3. Distinctive clinical programs. To have a true clinical enterprise, it must be a world class program. A world class program provides high quality care, coordination, technology, patient education and patient experience, according to Mr. Kardon.
4. Operations and facilities. For a successful clinical enterprise, Mr. Kardon said that hospitals should allow the physicians to govern the operations and facilities while providing a limited amount of oversight.
5. Primary care physicians. Hospitals must look at how they manage and work with primary care physicians in the market. "The goal is to align the primary care physicians with the specialists," said Mr. Kardon.
6. Financials. It is important for the hospital to start to discover the contribution margin and profit by modality and specialty. "We really don't know what things cost," Mr. Kardon said, but it is important to figure out, because patients are going to start shopping around by price. It is also important to find out competitor's rates, he said.