Integrating physicians with a hospital is becoming increasingly important as healthcare delivery shifts away from fee-for-service to those rewarding more coordinated care. One way to integrate physicians is to focus on a particular service line, such as cardiovascular services. By starting with one department, hospital and physician leaders can more easily consider the processes specific to a certain area of care. Successful alignment, however, requires careful planning, communication and cooperation. William M. Cherry, MHA, CHE, vice president of Paragon Health, a cardiovascular management and consulting company, shares six strategies for integration in the cardiovascular service line.
1. Insist on C-suite-driven discussions with physicians. Initial discussions with physicians must be driven by the C-suite, according to Mr. Cherry. Including the top executives in the alignment process from the beginning shows physicians that the hospital is serious about integration. It is important for physicians to know that the "individuals involved in discussions have the authority to make decisions," Mr. Cherry says.
2. Find common ground. "Identify areas that are common between physicians and the hospital. Use those as starting points for a discussion on the overall improvement of a service line," Mr. Cherry says. He suggests physicians and hospitals agree on national standards and external payor requirements instead of internal measures to avoid the perception that one side has more control or power over the other. For example, the American College of Cardiology provides information on practice guidelines and quality standards on its website.
3. Agree on key principles. Hospitals and physicians do not have to agree on every detail, but must agree on key principles for a service line to coordinate care. "Agreement on a common vision for program is probably the most important component [of integrating a service line]," according to Mr. Cherry. For instance, hospital and physician leaders should decide the strategic direction and short- and long-term goals for the service line.
4. Develop standard procedures. To create operational efficiencies, physicians should lead and jointly develop treatment protocols /care paths for treating patients. "A key component is having physicians sit down together and come to an agreement on the appropriate care path for patients with particular diagnoses," Mr. Cherry says. Examples of this include the appropriate treatment of heart failure patients, post coronary intervention patients or patients that transition from cardiac cath to open heart surgery.
5. Choose products together. One way to streamline healthcare delivery and reduce costs is for hospital leaders to discuss with physicians which products are necessary and work together when contracting with vendors. "Cardiovascular procedures are cost-intensive areas," Mr. Cherry says. "There are multiple vendors with multiple different products. Working together, evaluating a product and determining which products you actually use allow for essentially a single voice in the negotiating process." He says the benefit of this strategy is achieving cost savings without changing the type of product or patient care; the only change is collaborating as a team to negotiate prices.
6. Look at the big picture. Looking at the entire spectrum of a service line is critical to integration because it "allows for more comprehensive planning for that service line," Mr. Cherry says. One way to look at the big picture is to use financial models to predict how changes in a service line will affect both the hospital and physicians. Both the hospital and physicians should be involved in the planning process so leaders can make the best decisions. Mr. Cherry says physicians' services are closely connected to those of a hospital, and should thus be taken into account when developing strategies for care. As an example for the cardiovascular service line, he explains that patients may see a physician for outpatient care, but may require diagnostic testing and cardiovascular intervention at the hospital.
Learn more about Paragon Health.
1. Insist on C-suite-driven discussions with physicians. Initial discussions with physicians must be driven by the C-suite, according to Mr. Cherry. Including the top executives in the alignment process from the beginning shows physicians that the hospital is serious about integration. It is important for physicians to know that the "individuals involved in discussions have the authority to make decisions," Mr. Cherry says.
2. Find common ground. "Identify areas that are common between physicians and the hospital. Use those as starting points for a discussion on the overall improvement of a service line," Mr. Cherry says. He suggests physicians and hospitals agree on national standards and external payor requirements instead of internal measures to avoid the perception that one side has more control or power over the other. For example, the American College of Cardiology provides information on practice guidelines and quality standards on its website.
3. Agree on key principles. Hospitals and physicians do not have to agree on every detail, but must agree on key principles for a service line to coordinate care. "Agreement on a common vision for program is probably the most important component [of integrating a service line]," according to Mr. Cherry. For instance, hospital and physician leaders should decide the strategic direction and short- and long-term goals for the service line.
4. Develop standard procedures. To create operational efficiencies, physicians should lead and jointly develop treatment protocols /care paths for treating patients. "A key component is having physicians sit down together and come to an agreement on the appropriate care path for patients with particular diagnoses," Mr. Cherry says. Examples of this include the appropriate treatment of heart failure patients, post coronary intervention patients or patients that transition from cardiac cath to open heart surgery.
5. Choose products together. One way to streamline healthcare delivery and reduce costs is for hospital leaders to discuss with physicians which products are necessary and work together when contracting with vendors. "Cardiovascular procedures are cost-intensive areas," Mr. Cherry says. "There are multiple vendors with multiple different products. Working together, evaluating a product and determining which products you actually use allow for essentially a single voice in the negotiating process." He says the benefit of this strategy is achieving cost savings without changing the type of product or patient care; the only change is collaborating as a team to negotiate prices.
6. Look at the big picture. Looking at the entire spectrum of a service line is critical to integration because it "allows for more comprehensive planning for that service line," Mr. Cherry says. One way to look at the big picture is to use financial models to predict how changes in a service line will affect both the hospital and physicians. Both the hospital and physicians should be involved in the planning process so leaders can make the best decisions. Mr. Cherry says physicians' services are closely connected to those of a hospital, and should thus be taken into account when developing strategies for care. As an example for the cardiovascular service line, he explains that patients may see a physician for outpatient care, but may require diagnostic testing and cardiovascular intervention at the hospital.
Learn more about Paragon Health.