In a session at the Becker's Hospital Review Annual Meeting in Chicago on May 18, Ron Greeno, MD, chief medical officer for Cogent Healthcare, discussed the changing nature of hospital and medical staff as healthcare reform and reimbursement cuts place increasing pressure on healthcare systems.
Dr. Green began by discussing the increasing level of integration across the healthcare industry. "We're seeing the reemergence of hospitals and health plans buying physician practices," Dr. Greeno said. "We're seeing health plans buy independent practice association management companies."
The trend towards integration is a sign that goals of healthcare are changing. "It used to be that a busy practice is a successful practice, but that's not the model anymore," said Dr. Greeno. "We are not paid on volume, but performance. The whole model is going to be organization-centric and hospital centric."
Dr. Greeno said that the current challenge is to prepare for the future environment of increased integration and population health while growing and prospering in the current environment of fee-for-service payment and financial uncertainty. "This environment means increased risk, but also increased opportunity for hospitals and providers," he said. "Hospitals will need reliable physician partners to manage this risk. The winners will be the hospitals that are able to create innovative and enduring partnerships with physicians."
Successful relationships will share several features:
• Team based
• Supported by systems of care
• Data driven
• Enduring governance
• Design will be “organization centric,” not “practice centric”
• Shared goals, incentives, and risks
The medical staff of the future, meanwhile, will include the following:
• Inpatient physicians such emergency room physicians, hospitalists and critical care physicians who have primary accountability for the majority of hospital patients
• Supporting services provided by pathology, radiology and anesthesia
• Specialists will be specialists and will be as efficient as possible
• Administration, nurses, pharmacists and case managers will work with “inpatient physicians” in a system designed to improve quality, satisfaction, safety and cost efficiency
Dr. Greeno concluded by saying that the future of healthcare will make it difficult to remain in a fee-for-service world. "We will seek out alternative ways to get paid, and we will develop new models of care to manage patients in an inpatient and outpatient setting," he said.
Dr. Green began by discussing the increasing level of integration across the healthcare industry. "We're seeing the reemergence of hospitals and health plans buying physician practices," Dr. Greeno said. "We're seeing health plans buy independent practice association management companies."
The trend towards integration is a sign that goals of healthcare are changing. "It used to be that a busy practice is a successful practice, but that's not the model anymore," said Dr. Greeno. "We are not paid on volume, but performance. The whole model is going to be organization-centric and hospital centric."
Dr. Greeno said that the current challenge is to prepare for the future environment of increased integration and population health while growing and prospering in the current environment of fee-for-service payment and financial uncertainty. "This environment means increased risk, but also increased opportunity for hospitals and providers," he said. "Hospitals will need reliable physician partners to manage this risk. The winners will be the hospitals that are able to create innovative and enduring partnerships with physicians."
Successful relationships will share several features:
• Team based
• Supported by systems of care
• Data driven
• Enduring governance
• Design will be “organization centric,” not “practice centric”
• Shared goals, incentives, and risks
The medical staff of the future, meanwhile, will include the following:
• Inpatient physicians such emergency room physicians, hospitalists and critical care physicians who have primary accountability for the majority of hospital patients
• Supporting services provided by pathology, radiology and anesthesia
• Specialists will be specialists and will be as efficient as possible
• Administration, nurses, pharmacists and case managers will work with “inpatient physicians” in a system designed to improve quality, satisfaction, safety and cost efficiency
Dr. Greeno concluded by saying that the future of healthcare will make it difficult to remain in a fee-for-service world. "We will seek out alternative ways to get paid, and we will develop new models of care to manage patients in an inpatient and outpatient setting," he said.
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