Improving care processes and outcomes has never been more important as reimbursement systems and incentives change. Your employed group is the vehicle that can help you drive change throughout your system. Creating a network built on quality is the lynchpin of value-based reimbursement. That means defined clinical performance and customer service standards, and putting quality metrics in place that show payers you can produce results. It also means the nimbleness to respond to changing requirements as the market evolves.
Tip 17: Define metrics and measure them.
Tying appropriate clinical and behavioral performance measures to physician compensation is a great way to make them more tangible to physicians. Most physicians will impact what they understand and can measure.
Tip 18: Communicate quality initiatives.
Section leaders vary in communication ability, so communicate electronically and in semi-annual meetings of the full provider group as well. Incentive plans are another great vehicle to get the word out.
Tip 19: Use evidence-based guidelines.
Incorporating best practices into the EHR and patient assessments are great ways to do this with primary care practices. Otherwise, initially focus your energy on the disease management issues most costly to payers, such as diabetes, COPD, heart failure, etc.
Tip 20: Celebrate achievements.
Public recognition is a good mechanism and can also be incorporated into the marketing of the group. Communicating these achievements can help build a strong brand valued by customers, as well as enhance the culture.
Tip 21: Never lose focus on patient satisfaction.
Measure each physician against expectations for interaction during the appointment and timeliness of service; incorporate these expectations in performance evaluations.
Tip 22: Maximize the value of your EHR.
Use the system to drive preventive practices in the primary care setting. Most organizations do not fully use all the capabilities of EHR platforms. EHRs are big investments, take advantage of them!
Tip 23: Leverage care management knowledge with employers.
Begin to facilitate interactions between local employers and physician leaders. Convincing employers that the group can help with care management and quality issues is a great business strategy to ensure you benefit from your investment quality initiatives.
Tip 24: Maintain referrals within the group.
Physicians should want to retain referrals due to the continuity it creates. Same group, same EHR, timely visits, feedback from specialists and quality services. Make referral retention a quality issue!
Tip 25: Hire and retain the right physicians.
Behavioral interviews and testing should be utilized, even when the physician is a known quality. Groups need to focus on the physician’s cultural fit, not just on clinical knowledge. Getting rid of physicians is difficult. It’s much easier not to hire them.
Tip 26: Focus on results desired by payers.
Make sure you maximize reimbursement and make sure insurers recognize your efforts. Begin to turn an adversary into a strategic partner.