In a presentation titled “Clinical Variation, Quality and the Role of the CMO,” at Becker’s Hospital Review Annual Meeting on May 17 in Chicago, Bill Mohlenbrock, MD, FACS, chairman and CMO of Verras discussed the importance of a chief medical officer and the involvement of physicians in hospital leadership.
“If we are going to do what we need to do to improve quality and cost savings, we have to get the physicians involved,” said Dr. Mohlenbrock. “The CMOs I speak with would love to have the opportunity to sit down one-on-one with physicians with granule information and let them know what they are doing well. What we want to do is see how we are going to integrate physicians and see what they are doing with case management.”
Hospitals should use data over a three year period of time and provide individual physicians with their own data to help them improve. There should be integrated cost and quality measures, which can be used to estimate the amount of resources you expect to save. Compare what you expect to save to what is actually saved and if you save less, figure out where the issue lays; it could be in documentation. If there is a wide variance between physicians in the group, talk to the physicians individually to see what the most efficient ones are doing and focus on areas for improvement of the other physicians.
“Our goal is to reduce variance by about 6 to 8 percent,” says Dr. Mohlenbrock. “When you reduce by just 6 to 8 percent, tremendous dollars are saved and quality is tremendously improved.”
When working with physicians, the information has to be granule and you should focus on what the surgeons are doing well, says Dr. Mohlenbrock. “You have to get a homogeneous patient group and look at them,” said Dr. Mohlenbrock. “Don’t try to create a pathway with DRG; patients are too heterogeneous. The point is the ability to show physicians what they are doing as individuals”
This includes showing how much resources they are using down to the specific drugs and the physician’s own performance compared to himself. The CFO should be able to show physicians how much money they have saved each quarter by reducing the variation in practice. Next, leaders should focus on the index of quality improvement, which amasses data from national hospital quality measures. The next step will be moving to bundled payments.
“For hospitals in a bundled payment situation to be able to say they’ve improved, you will get an additional $1.4 million,” said Dr. Mohlenbrock. “What percentage of that should go to physicians? If you don’t have quality metrics on the physicians, there will be push back. Decide what percentage should go to the orthopedic surgeons compared to the cardiologists and other specialists. We’ve got a sliding scale that shows the better physicians do, the higher reimbursement they get. If you have the clinical information at this level, you’ll be able to make the statements.”
“If we are going to do what we need to do to improve quality and cost savings, we have to get the physicians involved,” said Dr. Mohlenbrock. “The CMOs I speak with would love to have the opportunity to sit down one-on-one with physicians with granule information and let them know what they are doing well. What we want to do is see how we are going to integrate physicians and see what they are doing with case management.”
Hospitals should use data over a three year period of time and provide individual physicians with their own data to help them improve. There should be integrated cost and quality measures, which can be used to estimate the amount of resources you expect to save. Compare what you expect to save to what is actually saved and if you save less, figure out where the issue lays; it could be in documentation. If there is a wide variance between physicians in the group, talk to the physicians individually to see what the most efficient ones are doing and focus on areas for improvement of the other physicians.
“Our goal is to reduce variance by about 6 to 8 percent,” says Dr. Mohlenbrock. “When you reduce by just 6 to 8 percent, tremendous dollars are saved and quality is tremendously improved.”
When working with physicians, the information has to be granule and you should focus on what the surgeons are doing well, says Dr. Mohlenbrock. “You have to get a homogeneous patient group and look at them,” said Dr. Mohlenbrock. “Don’t try to create a pathway with DRG; patients are too heterogeneous. The point is the ability to show physicians what they are doing as individuals”
This includes showing how much resources they are using down to the specific drugs and the physician’s own performance compared to himself. The CFO should be able to show physicians how much money they have saved each quarter by reducing the variation in practice. Next, leaders should focus on the index of quality improvement, which amasses data from national hospital quality measures. The next step will be moving to bundled payments.
“For hospitals in a bundled payment situation to be able to say they’ve improved, you will get an additional $1.4 million,” said Dr. Mohlenbrock. “What percentage of that should go to physicians? If you don’t have quality metrics on the physicians, there will be push back. Decide what percentage should go to the orthopedic surgeons compared to the cardiologists and other specialists. We’ve got a sliding scale that shows the better physicians do, the higher reimbursement they get. If you have the clinical information at this level, you’ll be able to make the statements.”
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