Journal of Healthcare Management - May/June 2014 - (Page 198)

J o u r n al of H ealt H care M anage Ment 59:3 M ay /J une 2014 1,200 plus 530 advanced practice clinicians (nurse practitioners and physician assistants). Of these, 900 are employed and an additional 172 are clinically aligned with and integrated into the hospital. In response to organizational and physician practice needs, a team of senior leaders developed several different alignment and integration models to determine the most mutually beneficial agreement between physicians or practices and the hospital. Four agreement options were defined: medical directorships, professional services agreements, agreements for direct contract services and co-management of service lines, and a physician/practice lease arrangement. Physician-Partner Attributes Deciding which physicians with whom to align is as critical as the model chosen (Thomas, 2009). Prior to determining which model best suited a particular physician group, the leadership team assessed the group's level of readiness for alignment and integration. Key attributes, identified as being requisite for success (Table 1), had to be in place before discussions began. As conversations evolved, we found that successful alignment required commitment to and patience with the process, a common vision, and a robust relationship between the hospital and the physician group. A key aspect of identifying and resolving any differences between hospital and physician group strategies was selecting strong, respected hospital clinical leaders to drive these discussions. Once core attributes were identified and cultural fit ascertained, the next step was to choose the right model for the physician partner. Because our hospital has a longstanding culture of collaboration with physicians, we were able to establish trust early by listening to the physician groups, identifying the most capable group leaders, and selecting groups known by reputation for their clinical TA B L E 1 Core Attributes Necessary for Clinical Integration and Alignment Physician-Partner Attributes Description Commitment Demonstrated loyalty to each other Commitment to achieve mutual goals that address community needs Cultural Fit Complementary characteristics Compatibility for future goals Engagement Shared urgency to achieve greater access, improve care, and lower costs Relationship Strong relationship predicated on trust Collective strengths as a framework on which to build Mutual values for the future 198

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