As traditional models of healthcare delivery continue to undergo rapid upheaval, hospitals and health systems must adjust. Critical to their success is the ability to operate as a high performing medical group.
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As traditional models of healthcare delivery continue to undergo rapid upheaval, hospitals and health systems must adjust. Critical to their success is the ability to operate as a high performing medical group. The Health Care Advisory Board defines high performing medical groups as "organizations that have generated strong results by fostering a commitment to mutual success among physicians."1
A high performing medical group improves care coordination, engages patients and develops provider loyalty — all while improving quality and reducing costs, essential in the move to population management. But, how do you build a high performing medical group, and what critical elements must be in place?
Why build a high performing medical group?
Hospitals and health systems are currently experiencing a migration in care, with volume shifting from inpatient to outpatient. As a response to this and other market changes, organizations have relied on aggressive acquisition strategies to grow their physician ranks — yet many continue to manage practices as stand-alone units, believing that physicians prefer a "hands-off" management style.
Because physicians play a critical and direct role in any health care enterprise’s financial health (one study points out that physician orders are “directly responsible for 80 percent of [healthcare] spending.”2), the "hands-off" approach is problematic. It fails to capture the potential benefits of operating as an integrated organization: an expanded referral network, enhanced patient access, operational economies of scale, opportunities to improve quality and better care coordination.
With rising costs, changing payment models and patients seeking care in more varied settings, health system leaders are carefully reconsidering how their organizations can optimize productivity and performance — especially when needing to align large groups of acquired physicians.
Creating a high performing medical group can help health care organizations:
- Prepare for future payment models in a changing reimbursement environment;
- Manage the transition toward more integrated care delivery;
- Manage growth and productivity with a meaningful connection to employed and affiliated physicians;
- Better serve patient populations with increasingly patient-centric models of care delivery and management; and
- Meet the requirements of evolving clinical quality standards.
- Insourced solutions, or software-server models, where the medical center owns and runs the software and system infrastructure
- Fully or partially outsourced solutions, where the software lives on the vendor's system
- Cloud-based services, a combination of software, data and intelligence that's hosted and managed on the web, where users can securely access continually updated information. With one such cloud model, called a "co-sourcing" solution, the HIT vendor performs work on the health system's behalf to complement work performed by the organization's staff.
The right foundation
Managing the transformation of a disparate collection of caregivers into a cohesive, integrated, aligned group can represent a major investment. To ensure a smooth transition, organizations need the right foundation: communication and HIT infrastructure that provides maximum influence and control over performance, while supporting strategic goals and profitability.
Today, there are generally three approaches to HIT:
When all factors are considered, a co-sourced, cloud-based services solution is the only HIT offering that can deliver health systems a favorable total cost of "ownership." The cloud platform is already seeing widespread acceptance as healthcare providers' choice — a KLAS report found that 71 percent of providers were deploying or planned to deploy cloud technology.3 Required capabilities for high performing medical groups 1. The right information delivered to the right person, at the right time 2. Tools for strengthening physician loyalty Cloud-based platforms can be continually and instantly updated across an entire system, and can enable bidirectional communication between physicians and leadership; frontline providers stay updated on strategic decisions and can provide feedback up the chain of command. 3. Tools for accessing and engaging patients 4. Flexibility to accommodate new payment models It is more important than ever to have a technology solution that evolves with new reimbursement realities. With traditional software, reporting on meaningful use measures and preparing for ICD-10 compliance can require expensive upgrades and modules. A cloud-based, co-sourcing solution can offer built-in, behind-the-scenes support to research and anticipate changing guidelines without extra cost. 5. Optimized workflows 6. Insight to manage growth Bringing healthcare organizations into the futureTo perform at their peak, healthcare organizations need to start with their technology solutions. This is the foundation, the backbone that strengthens meaningful integration, growth and the ability to meet new quality standards, all while enhancing profitability. When considering today’s challenges — and the unforeseen changes on the horizon — cloud-based IT solutions have emerged as the only viable option to bring it all together, and help improve both financial and clinical outcomes. 1 Health Care Advisory Board. 2011. The High-Performance Medical Group: From Aggregations of Employed Practices to an Integrated Clinical Enterprise. 2 “Decline in Utilization Rates Signals A Change In The Inpatient Business Model,” Robert York, Kenneth Kaufman and Mark Grube, Health Affairs, March 2013. 3 KLAS. December 8, 2011. Healthcare Providers Test the Waters of Cloud Technology. 4 National Learning Consortium Fact Sheet August 2012.
Here are six capabilities all high performing medical groups must have:
Physicians need access to clinical data at the point of care to ensure a better patient experience and outcome. Executives and other stakeholders need performance data to make strategic decisions about growth and profitability. And an organization as a whole must be able to exchange information with entities outside its walls, a demand that cloud-based HIT services can meet by building interfaces to support that exchange seamlessly.
To drive physician loyalty, high performing medical groups need HIT solutions that facilitate care coordination, integrated order pattern reporting across the enterprise and closed-loop ordering. With these elements in place, it's easier for providers to work together across the enterprise, because:
Healthcare organizations with a strong patient engagement strategy — especially the use of an online patient portal — report increased efficiency via self-service check-in, automated appointment reminder and lab result services, and online and after-hours payment options. When secure messaging is introduced, telephone volume decreases. And portal features can lower indirect and direct labor costs, from the fees to deliver lab results through the mail to the time spent on the phone handling questions, appointment scheduling and patient reminders.4
A cloud-based service can embed updates into workflows where they are easiest for staff to capture and act on. This means information is available that enables providers to make high-value, high-quality clinical decisions at the point of care, and creates enormous efficiencies when it comes to revising paperwork and researching updates. Staff can spend the workday — and save money — concentrating on patient care and managing the enterprise.
High performing medical groups need tools to compare their organization's performance to best practices, design better workflows and uncover and fix "broken" processes. Because the cloud offers complete visibility into community ordering patterns, operations, clinical decisions, and financial performance, healthcare executives have the information necessary to make informed decisions about growth and acquisitions.