5 Best Practices for Achieving Successful Hospital-Physician Alignment

It's no secret that the healthcare industry is trending more and more toward hospital-physician alignment for many reasons. Hospitals are increasingly looking to align with physicians or physician groups in preparation for changing payment models under healthcare reform. Meanwhile physicians are leaning more toward hospital alignment in order to obtain greater resources, capital and financial viability. Here are five best practices for hospital leaders looking to improve physician alignment.

1. Understand the different types of hospital-physician alignment strategies. Luke Peterson, a partner with Kurt Salmon's Healthcare Strategy Group says hospital leaders should take time to fully understand the different strategic alignments hospitals and physicians or physician groups can share. Those strategies include shared business services, contractual relationships for specific physician clinical, managerial or investment services, structured communications and employment.

2. Foster physician leadership. Peggy Naas, MD, MBA, vice president of physician strategies at VHA, suggests seeking out leadership opportunities for physicians to collaborate with hospital administrators and gain experience in managing the hospital's and heath system's services.

"Look for physician leaders who can participate in committees; listen to them and start nurturing their understanding of the broader organization's work and the perspective of the board," she says. Physician leadership can take various forms in an integrated hospital. Two options include election, in which physician leaders are elected by their peers, and appointment, in which hospital leaders choose physicians for specific positions based on an application process.

3. Balance the clinical, financial, operational and vocational. Richard Afable, MD, MPH, president and CEO of two-hospital system Hoag Memorial Hospital Presbyterian in Newport Beach, Calif., says non-integrated systems, like Hoag, can achieve great physician alignment by finding a balance between four elements: clinical, financial, operational and vocational.

"How are we hoping to do this? Mostly by creating sustainable, mutually beneficial physician alignment. Not only between doctors and hospitals but also between physicians and physicians. And not employment; alignment," Dr. Afable says. "I find that employment is oftentimes light on the operational and vocational side. When you get those four elements in sync between a hospital and physician or physician group, the results can be remarkable."

4. Develop the physician group culture. Beyond the employment agreement, the development of a multispecialty group culture is the goal of most hospitals when employing physician practices. "Culture doesn't develop overnight," says Mr. Peterson of Kurt Salmon. The great multispecialty clinics have decades of culture supporting them. "The long history of working together creates the relationship and trust needed to form a permanent team," he says.

5. Expand physician affiliations through the right sets of knowledge and tools. To expand affiliation with physicians or other providers in the community, a hospital should have a portfolio of products and services that are needed in the community. "Critical to any and all services is the ability to capture stagnant data and turn it into proactive business and clinical improvement," says Patrick Hampson, chairman and CEO of MED3000. "You have to be able to add value to the delivery of healthcare or you won't have any long-term traction." These resources such as population health or predictive modeling may be more difficult for physicians to obtain in a small practice setting.

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