Page 4 - SFHN JAN 2022

Physician Integration - Whether It

Be Clinical or Otherwise: Perhaps It

Is Time to Focus on the Physicians

BY RICHARD KLASS, TOM CURTIS AND PAUL DEMURO, PHD

One may wonder why some stress that • Common use of proven individualiza-
for customers to come first, one must tion of care pathways for patients with co-
make their employees a priority; i.e., if you morbidities.
want happy customers, you need satisfied • Performance measurement tools that
employees. All too often, physicians measure clinical outcomes and those out-
become employees of hospitals, compa- comes are tracked and shared across stake-
nies backed by private equity sponsors or holders.
health plans, or part of large medical Most healthcare systems have shared
groups and/or Accountable Care patient electronic charts across the care
Organizations (ACOs), and they are not continuum. Physicians have the patient
truly integrated into the practice, and are information at hand and historical data is
not happy. Some even tell their physicians there for subsequent analysis. What is
that everything will be the same in the often missing is management ensuring
new model. organizational goals and aims are agreed
Many organizations strive for true clini- upon by the providers and care teams and
cal integration, an active and ongoing pro- dedicated resources are in alignment with
gram to evaluate and modify the practices desired outcomes.
of physicians in networks to facilitate a When physicians become employees of
high degree of interdependence and coop- large organizations, their quality of care
eration of its physician members with the and behavior become the subject of sys-
goals of improving care, reducing costs, tem-wide policies and the opportunity to
and improving access to care. Conversely, resolve quality or behavioral issues infor-
others focus mainly on ensuring their mally is often lost. Rather than receiving
physicians are engaged productive mem- collegial intervention, the employee of a
bers of their organizations. hospital, health plan or large medical
Healthcare is complicated. The time cli- group may be subjected to a formal disci-
nicians spend on non-patient care activi- plinary process in which the decision-
ties has significantly increased. Unfor - makers are system level administrators
tunately, organizational growth often with no knowledge of the physician as
comes with less transparency, less time for an individual. Harsh outcomes may
physician input, and discussion of what result from such reviews and the physi-
works for the clinicians and what does cian’s employment may be jeopardized
not. All too often, the prevailing system by events that were formerly resolved by
smothers physicians because they are anti- a conversation.
thetical to building a cohesive medical We need to revive the recognition that
group. These systems often include not an encounter involves a patient and a
only their compensation, but their work- physician and for the former to be satis-
flow, and ways to treat their patients. fied, it is important to be responsive to the
Incentive payment systems may even be needs and desires of the treating physician.
put in place without input of the physi- We need to ensure that physicians under-
cians, and the appropriate recalibration stand the data and data analytics. Systems
over time to account for a physician's spe- should be designed for the particular
cific patient population. patient population served and the treating
WRVU requirements to keep physician physician.
compensation levels often take priority Clinicians must have the tools to
over the factors that drive clinical integra- improve care in a cost-effective manner,
tion. WRVUs measure productivity, not and incentives designed accordingly. It is
the status of clinical integration. Key per- not sufficient to merely have a fair market
formance indicator (KPI) data collection value consultant declare that the compen-
and measuring systems monitoring clini- sation of the physicians is at the 50th or
cal integration effectiveness should vary 75th percentile. Physicians need to be
according to a health systems’ unique involved in these processes, including
characteristics. In general, the KPIs when health plan contracts are negotiated.
should measure the extent there is: Designer solutions need to be
• Coordinated care across the continu- employed, and starting tomorrow is too
um of healthcare services required includ- late.
ing supporting education and social serv-
ices. Richard Klass, President, 2CY, Inc., can be
• Patient and/or family involvement in reached at rklass@2cy4u.com. Tom Curtis is
care planning for all patients. a Partner at Nossaman LLP and Chair of the
• Primary care availability demonstrat- firm’s Healthcare Practice Group. He can be
ed by the mix of inpatient to ambulatory reached at tcurtis@nossaman.com.
visit volume. Paul DeMuro, Ph.D., is Of Counsel with
• Team effectiveness and cross referral Nossaman LLP. He can be reached at
within the healthcare system. pdemuro@nossaman.com.

4 January 2022 southfloridahospitalnews.com South Florida Hospital News