Journal of Healthcare Management - May/June 2014 - (Page 197)

p H ys I c Ian c lI nI cal a l IgnMent prioritizing cultural compatibility and setting clear expectations for achieving shared goals and ideals. In a study of 11,000 physicians in 69 medical groups, Budetti et al. (2002) found that many health systems did not align well with physicians. Even with a clear commitment to alignment, the hospitals did not pay adequate attention to the issues of importance to physicians, resulting in missed opportunities. The present article describes several models of clinical alignment and integration-short of physicians' employment with the organization- that were implemented at our large, community/academic health network with success for both parties. The stakeholders involved became interconnected parts of a hospital system that shared a common strategy, culture, and vision. ALIGNMENT C O N S I D E R AT I O N S Defining Clinical Alignment and Integration Hospital-physician alignment can be very complex and requires a wellthought-out strategy prior to implementation. For many physicians, especially those who have been practicing for several years, participation in an alignment initiative requires a change in the way they perceive themselves and their practices (HFMA, 2011). A balance, precarious at times, of independence and interdependence between the hospital and physicians must be maintained. In the past, quality healthcare could be provided by a single physician operating independently; however, as healthcare has become more advanced and I ntegrat Ion and specialized, physicians must collaborate in order to provide high-quality care (HFMA, 2011). Likewise, hospitals need to engage physicians as new models of care delivery evolve that focus on quality and efficiency (Kellis & Rumberger, 2010). Clinical alignment and integration agreements are refreshing alternatives to employment. They appeal to the many physician groups that prefer to retain moderate autonomy but are willing to dedicate themselves to one hospital to improve care and contain costs. The essence of clinical alignment and integration is an agreement between a hospital and physicians (or physician practices) to commit to delivering evidence-based care and improving quality, efficiency, and coordination of care while paying attention to costs. Metrics and targets that are designed to influence the clinical practice of all physicians and improve value for patients are supported by data-driven mechanisms and processes by which to monitor and manage utilization of healthcare services. Such agreements are tailored to the scope of the physician practice and the needs of the hospital while offering financial incentives to physicians to achieve mutually agreedon goals. We describe the efforts of a large, academic, tertiary care hospital in Pennsylvania that serves more than 800,000 people living in three area cities and their surrounding communities. Three campuses comprise the hospital, totaling nearly 1,000 beds, with 70,000 admissions and 175,000 emergency department visits in 2012. The hospital retains a physician medical staff of 197

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