Journal of Healthcare Management - May/June 2014 - (Page 196)

J o u r n al of H ealt H care M anage Ment 59:3 M ay /J une 2014 BACKGROUND There is an overwhelming need for change in the U.S. healthcare delivery system. Declining revenues and thinning operating margins are driving hospitals to further concentrate their focus on quality, costs, volume, and growth. Both hospitals and physicians are feeling the pressures of heightened patient expectations and the need to improve clinical and financial outcomes. To properly address these concerns, the way in which hospitals and physicians view each other must change. This pressure to change is nothing new. In the past, hospitals viewed physicians primarily as customers, providing unnecessary frills and unchecked autonomy. Then, in recent years, as more inpatient services shifted to the ambulatory setting, hospitals began to view physicians as competitors. Presently, with the dawn of accountable care organizations (ACOs) and an increasing focus on patient expectations, hospitals have begun to align with physicians as partners (HFMA, 2011). With the healthcare cost crisis looming, hospitals must seek methods of alignment that control costs without sacrificing quality of care (Kellis & Rumberger, 2010). An aligned physician medical staff committed to mutual goals and shared accountability helps ensure continued high-quality healthcare delivery in the ACO climate. The physician-hospital alignment model gaining the most momentum is the employment model, in which hospitals acquire physician practices and hire physicians in the community. This practice is similar to the large-scale physician employment and consolidation trend that hospitals experienced in the 1990s-a strategy designed to increase admissions in an attempt to protect themselves from the threat of reduced payments. The impetus for integration in the 1990s was purely economic; the strategy, based simply on acquisition, was largely unsuccessful (Harbeck, 2011). Today, alignment models are more mutually beneficial, driven by the need to establish collaborative relationships that focus on patient-centered care to improve quality and reduce costs. Additionally, physicians today are more inclined to pursue employment. Payment cuts and redesign, infrastructure costs, and the complexity of operating a physician practice have steered physicians toward the hospital employment model (Harbeck, 2011). In response, hospitals are taking inventory-of the physician practices in their markets, the needs of their community populations, their market shares, and their competitors (Harbeck, 2011). The new ACO environment challenges hospitals and physicians to join forces, focusing on strategies that are outcomes driven and that increase value to patients. To that end, hospitals need to develop and maintain strong relationships with their physicians. As not all physician practices are interested in being acquired (i.e., employed), hospitals must offer alternate strategies to align physicians on their medical staffs. Equally important, progressive hospital systems are seeking out physicians and physician groups with proven records of excellence and thus capable of authentic collaboration. The formula for successful integration requires 196

Table of Contents for the Digital Edition of Journal of Healthcare Management - May/June 2014

Journal of Healthcare Management - May/June 2014
Contents
Interview With Christopher D. Van Gorder, FACHE, President and CEO of Scripps Health
Successful Strategic Planning for a Reformed Delivery System
You, Inc.
Assessing the Feasibility of a Virtual Tumor Board Program: A Case Study
Physician Clinical Alignment and Integration: A Community–Academic Hospital Approach
Employer-Based Coverage and Medical Travel Options: Lessons for Healthcare Managers
Composite Model for Profiling Physicians Across Domains of Care

Journal of Healthcare Management - May/June 2014