Frontiers of Health Services Management - Summer 2013 - (Page 21)

Bringing the Care Together Beginning in 2010, we pursued the creation of a single physician enterprise across all of our regions, thereby bringing together our disparate employed groups. the rationale was simple: first, our care coordination brand would not be successful without a single physician brand. Second, we could not become physician driven if multiple voices were trying to influence our direction. finally, we would not transform our delivery model unless a singular physician influencer, along with other clinicians, was involved in that transformation. the work involved in bringing our physicians together could consume a separate article. Suffice it to say, 18 months of discussion, debate, and persuasion ultimately helped us to determine a shared vision for future care delivery and to recognize that we would either succeed together or not at all. the development of our shared vision was helped by our decision to create the Physician leadership academy. collaborating with the american college of Physician executives, we developed a curriculum to help physicians learn and master leadership skills. it afforded us a great opportunity for deep discussion with our physicians about our future environment and a sense of what it would take to be successful. in addition, it strengthened our collective sense that we were in this together. our first leadership class graduated in July 2011, and we are about to commence our third. the importance of the academy in helping coalesce our physicians cannot be overstated. We recognize this physician enterprise as a senior affiliate, equivalent to our hospital enterprises. its ceo has a seat at the system executive table and on our parent board. each region is treated equally regardless of size or revenue. inviting this level of involvement sent a powerful, critical message to our physicians. We also have the advantage in most of our regions of operating a single, strong Wil l ia m B . L e ave r , FAC H E • 21 f e a t u r e We then built a road map (exhibit 1) to achieve our strategic intent, in which physician alignment was the key to our ability to create value, that is, to coordinate care. We launched our initiative with an impressive array of capabilities already in place: great hospitals, excellent physicians, a single home care company covering most of our regions, our own fiber-optic network connecting all of our employed physician clinics and hospitals, a call center staffed by nurses around the clock, and a common it platform throughout our hospitals and clinics. although our employed physician base (most of whom were primary care physicians) numbered about 700, those physicians operated in nine groups, each with its own billing system and management infrastructure. in short, we had many of the elements necessary for a different delivery model, but they were not integrated, were not focused on the same objectives, or did not operate under the same incentives. the road map helped crystalize the path to a future delivery model and an understanding that care coordination could not occur without physician alignment. it also built on our assumption that patients will first look to their physician for guidance, counsel, and answers. So if we desired to manage care across the continuum or between silos, we had to put the patient and the physician at the center and build coordination capability around them. Because we realized that opportunities to demonstrate value or value-based contracting would appear at any time and not necessarily when we were completely ready, the road map was not assumed to be linear.

Table of Contents for the Digital Edition of Frontiers of Health Services Management - Summer 2013

Frontiers of Health Services Management - Summer 2013
Contents
Editorial
At the Heart of Integration: Aligning Physicians and Administrators to Create New Value
Volume to Value
Physician-Led Models of Accountability and Value: Observations on Payment Policy and Culture
Collaboration Across Clinical Silos
Breaking Down Clinical Silos in Healthcare

Frontiers of Health Services Management - Summer 2013