The state of hos­pi­tal-physi­cian re­la­tions: An ex­clu­sive sur­vey

Ex­clu­sive sur­vey on the state of hos­pi­tal-physi­cian re­la­tions of­fers good news for the part­ner­ships, but ques­tions over is­sues such as money and trust raise doubts about how long the har­mony will last

Modern Healthcare - - Front Page - John Mor­ris­sey

In a sub­ur­ban Chicago health­care mar­ket where com­peti­tors were steadily lock­ing up physi­cians as em­ploy­ees, 431-bed North­west Com­mu­nity Hos­pi­tal pur­posely sought doc­tors who wanted no part of be­ing on some­one else’s pay­roll.

“I po­si­tioned us as not be­ing a place to em­ploy physi­cians—this goes back 21 years ago—but rather a place for physi­cians who wanted to be in­de­pen­dent, en­tre­pre­neur­ial,” says Bruce Crowther, pres­i­dent and CEO of the Ar­ling­ton Heights, Ill.-based hos­pi­tal.

Times change. Though the de­lib­er­ate dif­fer­en­ti­a­tion “served us ex­tremely well over the years,” Crowther says, the hos­pi­tal re­cently closed on the ac­qui­si­tion of the largest physi­cian prac­tice on its med­i­cal staff. Plans are in the works to em­ploy hun­dreds more pri­mary-care and spe­cialty physi­cians.

At the other ex­treme, Billings (Mont.) Clinic merged with a com­mu­nity hos­pi­tal in that city back in 1993 and has purred along as a physi­cian-led, group-prac­tice-cen­tric or­ga­ni­za­tion with a sin­gle pa­tient record and billing sys­tem and well-aligned fi­nan­cial and clin­i­cal in­cen­tives for qual­ity and ef­fi­ciency.

But a new word was spliced into the clinic’s vi­sion state­ment for 2010: value—for pa­tients and pay­ers. “We re­al­ized that if you are not an or­ga­ni­za­tion that cre­ates value, you’re not go­ing to be poised for the fu­ture,” says Dou­glas Carr, the clinic’s med­i­cal di­rec­tor for ed­u­ca­tion and sys­tem ini­tia­tives.

The Pa­tient Pro­tec­tion and Af­ford­able Care Act, along with other eco­nomic forces and reg­u­la­tory wrin­kles, are driv­ing physi­cians and hos­pi­tal ad­min­is­tra­tions into each other’s arms, of­ten for strate­gic rea­sons but also for sur­vival in the face of de­clin­ing re­im­burse­ments. These forces will al­ter the ways hos­pi­tals and their physi­cians work with one an­other. To help mea­sure that change, Mod­ern

Health­care in part­ner­ship with Press Ganey As­so­ci­ates, a health­care per­for­mance im­prove­ment firm based in South Bend, Ind., con­ducted an in­dus­try­wide sur­vey on the state of hos­pi­tal-physi­cian re­la­tions and how they may change given a host of po­ten­tial ob­sta­cles. Of the 193 re­spond­ing or­ga­ni­za­tions, 94% em­ployed at least some physi­cians.

“The re­sults of this study in­di­cate that the re­la­tion­ship be­tween hos­pi­tal ad­min­is­tra­tion and em­ployed physi­cians is gen­er­ally pretty

Carr: Providers now need to fo­cus on cre­at­ing value.

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