Frontiers of Health Services Management - Summer 2013 - (Page 4)

T oday’s US healthcare system is complicated by silos that segment payers, hospitals, and physicians. it is incapable of providing the type of integrated and coordinated care across a continuum that drives incremental value for patients and healthcare organizations. to truly transform the US healthcare system, greater alignment must occur between hospitals and physicians through clinical integration. change of any significance is almost always disruptive to the system it affects, as the components of that system are forced to alter current proThe US healthcare system’s cesses. Physician–hospital multi-silo culture will not integration is no exception, go quietly into the night, and even with strong evidence confirming its benand breaking the bonds efit, transformative inteof this traditional and gration can test the resolve hierarchical design will not of all parties involved. Piedmont Healthcare be an easy task. (PHc), a not-for-profit, integrated care delivery health system in georgia, recognized the potential to increase value through physician–hospital integration, specifically in cardiovascular (cv) services. in 2007, PHc created the Piedmont Heart institute, now known as Piedmont Heart, an integrated entity based on a foundation of total alignment between physicians and hospitals. initially forced to overcome numerous challenges, Piedmont Heart now serves as evidence that progressive innovation may initially be disruptive but ultimately delivers greater value to a health system and the patients it serves, and it is likely necessary to transform current models of care. the importance of breaking down silos in healthcare is broadly accepted, and the development of Piedmont Heart addresses only one type of silo. the US healthcare system’s multi-silo culture will not go qui- etly into the night, and breaking the bonds of this traditional and hierarchical design will not be an easy task. PHc views the path to transforming healthcare as two evolutionary curves. the first curve, which we refer to as curve a, represents the rise and eventual decline of an industry that makes no adjustments to address changing external forces and stakeholder demands. curve a in healthcare is based on volume and is provider-centric, silo structured, and driven by fee-for-service payment. to remain viable, healthcare organizations must move to a new curve, a new way of operating—curve B. this is the healthcare industry’s new model of success, based on value and integration that is patient- and population-centric and driven by global or bundled payments for the outcomes achieved. the gap between curves is significant. Healthcare organizations must learn to optimize performance in the current environment (curve a) while preparing to move to a new, innovative way of operating (curve B). a powerful vehicle for change that spans curves a and B is physician– hospital integration. integration is necessary in both curves and may be a prerequisite to transform healthcare delivery from curve a to curve B. Physician–Hospital Integration the term integration suggests a true alignment of vision and goals between multiple parties. Because organizational transformation requires an effectively integrated structure and culture, successful integration is much more than just a transaction between hospitals and physicians. Medaxiom (2013) describes the integration process as having three steps: 4 • f ro ntier s o f h ea lth s e r vic e s ma na g e m e nt 29 :4

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