As the uncertainty caused by the healthcare reform law continues to escalate, the pressure placed upon the private physician practice is becoming more intense. Given this uncertainty, the ability for physicians to participate in models which allow them the opportunity to work more closely together to increase clinical quality while concurrently creating a more efficient clinical practice becomes paramount. Achievement of these two goals also creates market opportunities as key stakeholders such as employers, health systems, payors, and government entities explore ways to align with high-performing physician networks. This opportunity is leading to short-term physician employment by a major integrated delivery system which comes with a multitude of challenges for all parties. Additionally, in order to drive full alignment, the integrity of the physician’s autonomy to practice medicine must be maintained to ensure the care process is consistent with the vision of the physician. Given these challenges, there exists the need to find integration models that allow physicians to work more closely together while maintaining a level of autonomy which is desirable to the physician.
As the current economic environment continues to place more focus on finding strategies and solutions that “bend the healthcare cost curve,” the need exists for employers, health systems, payors, and government entities to create the proper incentives with high-performing physician networks who possess the systems, infrastructure, and care processes to efficiently manage a large patient population. A high-performing network must have the appropriate structure to ensure that the value proposition to the employer, health system, payor, and government entity is achieved. This value proposition is quite simply to deliver patient care in a more coordinated, efficient, and cost-effective manner. The reward for the ability to achieve the value proposition is a financial incentive based upon the dollars saved by the high-performing network. This opportunity is substantial and the need is great. Additionally, the legal structure is important to ensure that the network can effectively contract with key entities as well as ensure that the proper controls are in place to avoid issues related to the Federal Trade Commission and Department of Justice.
At the Physician Strategy Group, we see this dynamic manifesting itself in many markets through either large-scale acquisitions of practices, merging of physician practices together amongst and across specialties, and the development of clinically integrated networks of physicians driven by either the large integrated delivery system within the market, the payor, or large physician groups. Each of these is governed and executed in many different ways, and the goal of the Physician Strategy Group is to be a strategic resource to the practices as they evaluate how best to react to these new models. The Physician Strategy Group desires to ensure that each of the physicians in our network is positively positioned to leverage the high quality of care provided to their patients.
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PSG has been an invaluable resource for us. They continue to proactively identify industry changes, distill them into relevant takeaways, and help us execute essential improvements throughout our organization. It is this fresh perspective that makes PSG such a strong partner. Because of this, we have been able to utilize their expertise to assist us with analysis and revision of key revenue cycle, operational, and patient experience processes.
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