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 […]

Developing a PHO: 6 Key Considerations

Payment and insurance reform have driven hospital/physician alignment over the past few years. With hospitals and physicians increasingly being held accountable for each other’s actions, the need for tighter integration has grown. The result: a spike in Physician-Hospital Organization (PHO) activity, with hospitals and health systems reviving PHOs that have languished since the ‘90s or […]
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Preparing for Emerging Delivery Models: PHO Development to Facilitate Value-Based Care Delivery

Physician-Hospital Organizations (PHOs) are experiencing a resurgence, as hospitals and health systems grapple with ACOs, Bundled Payments, narrow networks and direct contracting in the wake of healthcare reform. During this informative, 45-minute webinar, HSG Partner David Miller and Director Travis Ansel will cover: The PHO model’s benefits under payment reform. How PHOs are being used […]

Use These Five Strategies to Align with Independent Physicians

To many hospital CEOs, there are days when it seems as though every physician on the medical staff wants to be employed.  In reality, that’s not true — quite a number of physicians prefer to remain independent.  However, finding ways to align with key independent physicians without putting them on the payroll has its own set of challenges. […]

Re-Emergence of PHOs

Not everyone needs to become an Value-Based Care Organization (ACO) today. Some hospitals should consider developing a risk-friendly entity such as a Physician/Hospital Organization to address cost reduction targets for commercial insurers and large employers as a first step. These models typically pay for services at a discounted rate (e.g., Medicare levels) and provide bonuses […]