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The first step to recruiting and retaining physicians is to understand their priorities and values as well as the unique advantages your organization has to offer.A Survey of America’s Physicians: Practice Patterns and Perspectives conducted on behalf of the doctor advocacy group the Physicians Foundation, and released in September, offers some interesting insights into this area from the 13,575 physicians surveyed.
As medical director of Holy Cross Physicians Partners (HCPP), a physician-led clinically integrated network (CIN) in Fort Lauderdale, I am particularly interested in the respondents’ thoughts on healthcare reform and its effects on their practices. While nearly 22 percent said their practice or employer is actively seeking designation as an accountable care organization (ACO), three in four said their practice or employer is either not seeking that active designation or they don’t know.
The Affordable Care Act is going forward and the insurance companies know it. In the commercial market it makes sense for insurance companies to promote better patient care through CINs and ACOs that provide a win-win-win scenario for patients, insurance companies and providers: aggressive use of information technology and the improvements it enables through the metrics it provides keep patients healthier; healthier patients require less long-term services which reduce insurance company costs; and savings are parlayed back in a reimbursement system that rewards providers for quality and managing risk.
The future is already here. On January 1, HCPP will begin seeing patients whose care is covered under HCPP’s first contract with an insurance company payer. HCPP has attracted 250 physicians and that is not surprising since CINs align with the issues that are top of mind of the respondents in the Physicians Foundation survey:
Increasing Satisfaction: The top three factors physicians cite as being "most satisfying" about a medical practice are patient relationships, intellectual stimulation and interaction with colleagues. HCPP is led and governed by physicians. Integral to CINs is the collaboration among its members to institute best practices and improve care for its patients. Keys to success include understanding the science and reasoning behind each protocol and tracking, analyzing and planning to progress toward goals.
A New Look at Reimbursements: After liability issues and defense medicine pressures, the top factors physicians identify as finding "least satisfying" about a medical practice are dealing with Medicare/Medicaid/government regulations and reimbursement issues. Currently, HCPP is focusing on the commercial payer market while developing the necessary infrastructure to enable it to evolve into an ACO that could accept and manage Medicare enrollees should it elect at some point to do so. At HCPP, physicians oversee the negotiation of contracts and seek contracts that provide appropriate base-rate compensation with additional performance-based bonuses and incentives. HCPP physicians also determine the targeted quality metrics and the distribution of the performance dollars.
Electronic Health Records: While nearly 70 percent of those surveyed had implemented electronic medical records, those who had not cite cost and a lack of resources or expertise as primary reasons for delay. CINs, especially those aligned with a hospital, can help physicians with IT and provide the tools needed to share information. Beyond the technology upgrades, CINs may be able to assist with Medicare initiatives such as meaningful use and the Physician Quality and Reporting System.
I am convinced that physicians will see great value in joining a CIN or ACO as healthcare reforms are instituted. As the survey indicated, the task before us is educating more physicians about the structure of these organizations and the role they can play in improving patient care and increasing career satisfaction.
