Case Studies

Case Study: Avoid Stark Issues through Contract Management

    This case study shows how a physician contract management system can help hospitals uncover Stark issues and smooth the contract negotiation process.   Background A community hospital in the Northeast was struggling to manage its contractual relationships with employed and independent physicians. Hospital leadership did not have a systematic approach to creating or […]

Case Study: Physician Contract Review

Background A community hospital in the Northeast was struggling to manage its contractual relationships with employed and independent physicians. Hospital leadership did not have a systematic approach to creating or managing physician deals, and as a result, faced the following problems: Contract terms were highly inconsistent across deals, with several executives engaged in physician deal […]

Case Study: Building a Health-System-Level Physician Strategy

Background A statewide system in the Southeast was struggling with decentralized decision making in its physician network. With no system-level plan in place, executives at the system’s six hospitals were implementing different physician recruitment and alignment strategies that did not support the overall organization’s strategic vision. In addition, centralized physician network resources were being asked to manage […]

Case Study: Developing Physician Leadership for an Employed Physician Network

This case study demonstrates how to develop physician leadership in an employed physician network through creation of a physician advisory council.   Background: This Southeastern hospital system serves a county with a population of about 500,000. They had a good-sized employed physician group, with well over 100 physicians, but most were hospital-based or specialists hired […]

Case Study: Cutting Physician Network Losses

Background The client was a nine-hospital health system with 14 clinics serving communities in a multi-state market with very limited access to care, poor economic conditions, high unemployment, and a heavy Medicare/Medicaid/uninsured payer mix. For most of these communities, the system was the sole source of care. Though the clinics were of substantial size (they employed […]

Case Study: Developing a Clinically-Integrated PHO to Align an Employed Physician Network and Independent Community Physicians

Background A large multi-specialty physician group (wholly owned and operated by a four-hospital health system) took a 25-percent upside/downside risk as a percent of premium on 6,000 Medicare Advantage (MA) patients. After realizing losses of over $1 million the first year, they determined tighter alignment with key independent specialist groups was necessary to better manage […]

Case Study: Developing a Strategy for a Rapidly-Growing Physician Network

Background A two-hospital system in the Midwest had a 45-provider employed network that had grown tremendously over three years. Much of that growth was unplanned and primarily based on reactions to competitor actions and physician demands. The result: Practice losses were exorbitant. The management team was focused on day-to-day issues and putting out fires. Multiple executives […]

Case Study: Creating a Successful Oncology Co-management Relationship

Co-management agreements can be mutually beneficial to hospitals and physicians. They can improve quality, reduce cost, and provide financial benefits to participating physicians. However, proper execution is required to realize these benefits. We recently worked with a client to implement an oncology co-management program and have translated our experience into the tips below. Background A […]

Case Study: Interim Management for an Employed Physician Network

Background Our Midwestern hospital client had a rapidly-growing employed physician network. The network was multi-specialty and was deployed to expand the hospital’s footprint in outreach markets. Developing the group culture and increasing physician engagement, however, were becoming increasingly challenging. The group lacked a solid infrastructure and didn’t have sufficient dedicated resources to support the practices […]