At the 18th Annual Ambulatory Surgery Centers Conference in Chicago on Oct. 28, Kate Lovrien, senior manager, and Luke Peterson, national director of the strategy group, Kurt Salmon Associates, discussed the future of physician-hospital alignment in the post-reform environment.
“From our research and advising, we found that alignment is very different than integration,” Ms. Lovrien said. “It doesn’t look at the structural models but the philosophical areas. It’s really around, ‘how do you create that engaged team?’”
Mr. Peterson outlined the three elements of physician-hospital alignment:
1. Economic alignment
2. Clinical activity alignment
3. Alignment of purpose
Clinical activity alignment is all about how the hospital and its staff practice medicine. Alignment of purpose focuses on engaging and inspiring the hearts and minds of all the individuals working at a hospital. Historically, Mr. Peterson said, hospitals have focused on ambulatory surgery centers to provide the economic alignment for physicians. New regulation, bundled payments and accountable care organizations have changed that dynamic.
“What really changed was not so much the economics of this, but the dialog about the continuum of care and looking at the whole person,” he said. “The focus suddenly shifted to the ASC to play a different role. Yes, it’s about volume and economic alignment, but more it’s about being aligned to the hospital.”
One of the ways an ASC can help physician-hospital alignment is in the area of clinical activity because there’s a focus on efficient and low-cost surgeries, Ms. Lovrien said.
In the past, many hospital executives viewed ASCs as taking away surgery cases from the hospital’s OR, but with the new economics of bundled payments, it’s about moving patients to the most effective market. Oftentimes, that is an ASC, Mr. Peterson said.
“At this point, it now becomes part of the large continuum of care,” he said. “We’re starting to talk about how they are going to fit into a bundled care pilot. If we have a bundled payment, how do we move patients to the most effective market? We’re not taking from one pocket and putting it into the other; it’s the same pot.”
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“From our research and advising, we found that alignment is very different than integration,” Ms. Lovrien said. “It doesn’t look at the structural models but the philosophical areas. It’s really around, ‘how do you create that engaged team?’”
Mr. Peterson outlined the three elements of physician-hospital alignment:
1. Economic alignment
2. Clinical activity alignment
3. Alignment of purpose
Clinical activity alignment is all about how the hospital and its staff practice medicine. Alignment of purpose focuses on engaging and inspiring the hearts and minds of all the individuals working at a hospital. Historically, Mr. Peterson said, hospitals have focused on ambulatory surgery centers to provide the economic alignment for physicians. New regulation, bundled payments and accountable care organizations have changed that dynamic.
“What really changed was not so much the economics of this, but the dialog about the continuum of care and looking at the whole person,” he said. “The focus suddenly shifted to the ASC to play a different role. Yes, it’s about volume and economic alignment, but more it’s about being aligned to the hospital.”
One of the ways an ASC can help physician-hospital alignment is in the area of clinical activity because there’s a focus on efficient and low-cost surgeries, Ms. Lovrien said.
In the past, many hospital executives viewed ASCs as taking away surgery cases from the hospital’s OR, but with the new economics of bundled payments, it’s about moving patients to the most effective market. Oftentimes, that is an ASC, Mr. Peterson said.
“At this point, it now becomes part of the large continuum of care,” he said. “We’re starting to talk about how they are going to fit into a bundled care pilot. If we have a bundled payment, how do we move patients to the most effective market? We’re not taking from one pocket and putting it into the other; it’s the same pot.”
Related Articles on Physician Management:
Adrian Gostick, Author of the "The Carrot Principle," Talks Employee Engagement at the 18th Annual ASC Conference
Changing Relationships Between Orthopedic Physicians, Hospitals and Payors
How to Fix a Troubled Hospital-Physician ASC Joint Venture