This article lays out 10 priorities for improving the performance of employed physician networks during 2016.
Reimbursement shifts from CMS and private insurers mean health systems today are facing a turbulent environment. Employed physician networks remain your best asset for addressing these challenges. We recommend working with your physician leaders to determine which of these 10 priorities are most pressing and developing tactics to drive improved performance.
Further consolidation. One of the best strategies to guarantee continued market relevance is to grow. Size equals leverage if you grow with strategic intent. Your network should consider two options:
- Geographic growth to new markets to improve access and share.
- Capabilities growth in the form of new specialties and doctors.
Address Population Management. Proceed with building the infrastructure to manage populations at a deliberate pace. A readiness assessment focused on key tactics vs. theory will help you define gaps. A key first issue is the physician culture and their knowledge of impending market changes. Your organization should aggressively move to close those gaps with physician direction and guidance.
Focus on Employers. Our average client makes 142 percent of their profit from private employers. Employers have the cash you need to fund investments in both capital and population management. Don’t continue to allow insurers to control these relationships. The expertise your health system and employed physician networks can deliver to employers is significant; begin using it as a weapon.
Focus Your Employed Network. Put energy behind efforts to engage physicians and build a common vision for how the group will evolve. Almost all hospitals are struggling with this issue. Building a common view of the world, building physician leaders to help move their peers, and defining strategic priorities are essential activities for your group.
Developing Leadership Roles for Physicians. Most organizations need to define new and increased roles for physicians. Expanded physician roles are required to deal with the evolving market. Your organization needs to define how you will identify physicians with leadership skills and build those skills.
Patient Satisfaction Focus. As in hospitals, patient satisfaction will soon influence physician reimbursement. The sophistication of the systems to measure and improve satisfaction in the practice environment is often not great. Having the management infrastructure to manage this outcome will be increasingly crucial.
Measuring and Improving Outcomes. Beyond patient satisfaction, physician reimbursement will also increasingly depend on your practices’ ability to produce consistent outcomes. Most employed networks are in the process of building these capabilities. Working with your physician leaders to define desired outcomes and to measure and improve outcomes dictated by CMS (and private insurers) has never been more important. This is the year to increase your mastery of this challenge.
Building Access. For many employed networks, access is a vexing issue. While health systems have employed physicians, they haven’t necessarily taken control or demanded compliance with scheduling. We increasingly see clients guaranteeing access within 24 hours. The need for greater compliance is creating management challenges but also opportunities.
Measured Cost Reductions. Within the physician enterprise, cost control deserves more focus. We recommend a measured approach built around productivity measurement and improvement. Those measures should apply to both providers and staff.
Physician Financial Acumen. Your physicians will be required to address new challenges under risk contracting:
- managing patients under bundled pricing; and
- managing populations under direct contracting and programs such as ACOs.
Your organization must make a focused effort to educate your physicians and provide financial data to help them understand the implications of their decisions.
Some of these potential priorities are multi-year initiatives. They will require persistence and patience, and big commitments for you and your physicians. But all of these potential priorities need consideration as you move into 2016.