Healthcare Leadership Network of
the Delaware Valley:
Physician Alignment
June 2015
Christine Winn, FACHE
Senior Vice President, MD Anderson Cooper
Cancer Institute and Cooper Physician
Alignment
Overview
• Why is this important?
• What has happened in the past?
• Variety of Physician Alignment Models and
Preparation Tactics
– Local Impact
• Necessary items for your “journey”
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Why is this important
• Operating costs will need to be reduced by 15
percent to 25 percent to ensure continued
viability in the value environment
• Physicians are a driver of costs and are THE
major partner needed to reduce those costs
• Current alignment activities can prepare
Healthsystems to be cost competitive in new
models
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ACHE Focus on Physicians
• New Physician Executive Forum
• Physician Leadership “Boot Camp” Pilots
• Career Development Task Force
– Physicians as members
• New Strategic Plan – Desired Outcomes
– Increased membership and participation across the
spectrum of healthcare leadership
– Higher levels of member engagement and satisfaction
– Increased brand awareness and perceived value among
members and key constituents
– Greater impact in advancing effective and efficient
healthcare
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What has happened in the past with
our physician colleagues?
• BUYING SPREE
• Not what we expected….loyalty cant be
bought?
• Healthsystem and physician alignment
– Co Management
– Gainsharing
• Value Based Collaboration Models
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VARIETY OF ALIGNMENT MODELS
AND PREPARATION TACTICS
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Building a Successful
Physician Alignment
Strategy
Mutual
Success
Clinical
Integration
Integration
Building Common Vision
and Culture
Physician Employment Strategy
Alignment
Economic Alignment Options
Medical Staff Growth and Development
Physician Manpower Planning
Source:
Healthcare
Strategy Group
Planning
Strategy
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Kurtsalomon, 2013
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Focus Areas for Alignment Activities
• Volume Based Care
– Focused on Employment
– Fixed Compensation
– Committee Service
Compensation
– Defend Market
– Competitive Advantage
with subspecialists
• Value Based Care
– Promotes Integration
and alignment of
incentives
– Focus on quality across
continuum
– Need for common IT
platforms
– Preparation for Bundled
Payments and ACO’s
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What are key Physician/Healthsystem
Collaboration Forces Now?
• Pay for performance reimbursement approaches
• Regulatory requirements are increasing
• Migration of physicians from inpatient to outpatient settings (loss of
connection)
• Need to recruit additional physicians places a risk on existing
physicians
• Newer physicians want predictable hours and an income guarantee
• Practice expense stress financial viability of independent practices
• Large employers and Medicare are moving to bundled payments,
single price contracting, and pay-for-performance
• Long-term success of the healthcare system
Source: Nick Fabrizio, PhD, FACMPE, FACHE, MGMA consultant
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LOCAL IMPACTS – COOPER
EXPERIENCE
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Cooper Fast Facts
Employees
4,666 full-time, 1,337 part-time
Patient encounters
6,003
1.3M+
Admissions
26,624
ED visits
81,075
Outpatient visits
Medical Staff
1.2M
1,004
Employed physicians
541
Community physicians
266
Allied Health professionals
197
Residents and Fellows
313
Licensed beds
Includes 35 NICU and Transitional Newborn Bassinets
635
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Cooper Medical School of
Rowan University
•
Opened in 2012 on the Health Sciences
Campus in Camden, New Jersey.
•
The first new medical school in New
Jersey in over 35 years and the only fouryear MD-granting medical school in
South Jersey.
•
CMSRU has quickly become a sought
after medical school in the country
because of its focus on community.
•
CMSRU addresses the physician shortage locally and nationally, and its students and faculty
continually work to find innovative improvements to health care throughout the region.
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The need to meet our academic mission remains
while we strive to address the triple aim
Amidst a
cultural shift
1
QUALITY
COST
Improve the
health of the
population
Reduce the
cost of care per
capita
Triple
Aim
2
SERVICE
Enhance the patient
experience
3
Academic mission:
Education & research
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Academic Medical Centers like Cooper walk a
fine line to strike a balance between volume and value
VOLUME (Old Order)
VALUE (New Order)
• Health system business models
focused on high margin, hightech inpatient care
• Fee-for-service payment for
activity volume and “carve outs”
• Advanced subspecialty care for
the complications of advanced
disease
• Specialty focus on care
innovation
DESTINATION CARE
Product & Services
Differentiation
• Health system business models
focused on quality and efficiency
of care management across the
full continuum
• Bundled/global payments and
incentives for outcomes
• Proactive health management
• Innovation around process
integration across providers
The Balancing Act
COMMODITIZED CARE
Operational Efficiency
Customer Service
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Health System Trends: Volume to Value
Capabilities for
Value-Based Care
Timing
Matters
Value-Based
Contracts
Premature
Well-Timed
Lagging
Contracts before sufficient
capabilities to be successful on new
arrangements
Transition contracts strategically
while building capabilities.
Delay building capabilities and
focus on fee for service – and risk
being caught unprepared
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Cooper aims to be the partner of choice
Making Cooper the partner of
choice….
…allows us to pursue a range of
collaboration options
Cost Advantage
1. Clinical affiliation
Efficient Product
2. Regional
collaborative
Payor Contracts
3. Accountable Care
Organization
Tertiary Care Capabilities
4. Clinically integrated
network
Service excellence
5. Merger or
acquisition
Risks and rewards
Quality Outcomes
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Cooper continues to position itself for the future
Expense
reduction
Improved
quality
Transforming
the culture
Building
relationships
with community
hospitals
Focus on quality
and access
Supportive
partnership
position
Cost advantage
among peers
Programs of
Distinction
Only Academic
Med Ctr (AMC)
in South NJ
DESTINATION CARE
Product & Services
Differentiation
Payor contracts
i
The Balancing Act
Shifting
improvement
focus to
Ambulatory
COMMODITIZED CARE
Operational Efficiency
Service Excellence
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Checklist for Necessary Physician
Alignment Items
Map
Menu
Stopwatch
“Spidy Sense”
Team
Catcher
Yoga Mat
Watering Can
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THANK YOU!
WINN-CHRISTINE@COOPERHEALTH.EDU
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