HSG Advisors_Physicians in employed networks understand the wide-ranging benefits of collaborating with and/or supervising Advanced Practice Providers (APPs).


Physician Compensation
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Physicians in employed networks understand the wide-ranging benefits of collaborating with and/or supervising Advanced Practice Providers (APPs). However, beyond being readily available to discuss specific elements of immediate patient care, physicians typically feel weighed down by the process of performing required quality of care reviews. Changing perceptions and enhancing protocols can greatly improve physician and APP morale as well as the quality of each review. By approaching reviews with a shared purpose, rather than viewing them only as regulatory-driven requirements, health systems, physicians, and APPs can mutually benefit from practical, sustainable solutions with favorable outcomes.  

The following is worth noting–while the state requirements for APP oversight apply to every type of practice, experience indicates that physicians and APPs in small independent practices may not be accustomed to adhering to well-defined programs, whereas physicians and APPs in health system employed networks tend to be subjected to more formal compliance programs. This difference in understanding may need to be considered during the transition of formerly independent physicians and APPs into an employed network relationship in order to avoid additional transitional culture shock.  

Before diving into specific review processes, it is helpful for health systems to take a step back to identify gaps in

both program process and understanding. States regulate APP oversight and typically require quality of care

reviews, however, not all state requirements are identical and most do not delineate specific review requirements.

By approaching APP reviews with a shared purpose, rather than viewing them only as regulatory-driven requirements, health systems, physicians, and APPs can mutually benefit from practical, sustainable solutions with favorable outcomes.

Considering these circumstances, developing a well-defined review process depends on knowledge of the state’s requirements and a reasonable understanding of which criteria will validate competencies while adding value to the final report, which forms the basis for stipend payments. Identifying programmatic gaps can lead to program improvements and create a more solid foundation for interactions and oversight.

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Terrence R. McWilliams, MD, FAAFP

Chief Clinical Officer and Managing Director, Employed Provider Networks