How Can Health Systems Unite Employed and Independent Physicians?

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In an era of health system consolidation, we’ve observed an intriguing new trend: complementary strategic alliances. KaufmanHall identified and aptly summarized this shift in their report on mergers and acquisitions (M&A): “In many instances, mergers between large systems are driven by complementary capabilities. The strength of one partner’s clinical capabilities, for example, may be complemented by the other partner’s health plan capabilities.” This activity can lead to “a more fully integrated system that can provide healthcare across the continuum of care,” as Ken Marlow, Healthcare Department Chair at Waller Lansden Dortch & Davis, noted for Modern Healthcare about the recent $17 billion Beaumont-Advocate Aurora merger.

While these partnerships are exciting, they can dominate the conversation and overshadow another crucial partnership, that between employed and independent community physicians. Data shows the number of physicians employed by hospitals increased by 14,000 between 2016 and 2018. An overlooked component of this consolidation is the need for alignment. Simply put, employment does not equal alignment.

Alignment between employed and independent physicians grows increasingly important as we move toward value-based care. How can we improve alignment to benefit physicians, health systems, and — most importantly — customers?

Implement Governance

Clinically integrated networks are not necessarily well-integrated, and accountable care organizations without aligned incentives can end up costing health systems. To enhance communication between employed and independent physicians, appropriate governance is essential.

The governance structure should, ideally, be led by physicians to build collegiality and elevate the clinical voice in decision-making and determining best practices. When doctors decide what metrics and outcomes to strive for, they’re more likely to support and adhere to the plans. After all, no one understands the unique needs of a customer population better than the physicians and providers who interact with them on a daily basis.

However, data and analytics are necessary as objective measures of performance. In my experience, physicians enjoy these measures as doctors are competitive by nature, always striving to do whatever they can to help their customers. According to a survey by the HealthCare Executive Group (HCEG), “Leveraging advanced analytics and new sources of disparate, non-standard, unstructured, highly variable data,” such as history, labs, the Internet of Healthcare Things, socioeconomic, and more, can “improve health outcomes, reduce administrative burdens, and support transition from volume to value.”

Ramp Up Technology for Customers and Physicians

Not only is healthcare moving from volume to value, it’s increasingly dependent on technology. The COVID-19 pandemic has demonstrated and solidified the need for a tech-forward approach to customer care. Thanks to telehealth, physicians were able to maintain customer volumes, reassure customers during uncertain times, and manage complex or chronic conditions while reducing risk of exposure to the coronavirus by allowing customers to connect with their provider from the comfort and safety of their own home. To meet customers’ needs, health systems should have telehealth that is available for scheduled appointments as well as on-demand.

Telehealth is especially effective when paired with a robust patient portal. Patient portals help keep customers engaged between visits by allowing for secure, asynchronous messaging with their care team as well as access to lab or test results. The portal can offload administrative work as well, such as billing and appointment scheduling.

Both telehealth and the patient portal integrate with a health system’s electronic health record (EHR). Furthermore, health systems should aim to unite both independent and employed physicians on a common EHR. While interoperability has come a long way, we are still far from a “Blue Button” option that would seamlessly and easily transfer health information. The upfront costs of additional licenses and onboarding are offset by the value of having all providers on a single platform. Additionally, a high-performance EHR can help close care gaps using patient-reported data, saving physicians and providers time while potentially improving health outcomes. In short, a single-instance technology platform can ensure a seamless customer experience and consistent data, reporting, and workflow components in all practice locations, which in turn helps health systems succeed in value-based care.

Health systems are an essential part of the healthcare landscape — as are independent, community physicians. By utilizing technology and shared governance, these two groups can achieve greater alignment to advance value-based care and improve the lives of customers.

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