- Formal onboarding processes increase physician retention.
- Successful onboarding requires physician buy-in to organization mission.
- Effective population health management relies on transparent performance data.
One of the biggest challenges fast-growing healthcare organizations face is how to integrate new physicians quickly, but effectively. Since 2014, Privia Medical Group, a venture-backed organization based in Arlington, Virginia, has brought 1,100 providers and more than 2,000 staff into its network — with up to 10 new practices going live every Tuesday.
And at a time when practices face a constant barrage of change, Privia’s new doctors also prepare to transition from fee-for-service to population health management in just four months. How do they do it? A methodical onboarding process that involves training, education, and plenty of targeted metrics.
In an ongoing project, athenahealth researchers are examining key financial and operational metrics from across a national network of 99,000 providers and have identified the top 10 percent of performers. Privia is one of them. And, like many high performers across the network, Privia has carefully designed its onboarding experience — and uses the process to encourage collaboration among data-driven clinicians and managers.
That’s especially critical for Privia’s physicians, says Rishi Seth, Privia’s director of implementation. To cross the divide from volume- to value-based patient care, he says, they will need to utilize key “best practices” in their clinical and administrative work,
“Changing from sick care to well care requires not only a new mindset, but a new infrastructure,” says Seth. “What we’re doing is much more complicated than technology implementation. We’re truly improving the way these providers practice and run their business.”
Onboard in four stages
At Privia, a four-stage process starts with “implementation teams” — groups of experts lined up to help new practices with revenue cycle management, finance and analytics, IT, marketing, and the network’s EHR. Additional help comes from clinical operations, the central business office, and customer support teams, which work onsite and remotely with all physicians and staff.
The goal is to “help practices operate in a more sophisticated manner,” says Seth. “Our team is dedicated to making this challenging transition as easy as possible.”
The next step in the process is assessment. The team reviews every practice’s payments and banking, certifications and insurance policies, workflows, IT systems and interfaces, and any additional IT needs.
The third phase is education. Physicians and staff complete role-specific online e-learning courses, followed by in-person onsite and classroom training.
The fourth phase prepares a practice to go live on Privia’s network: converting clinical charts, uploading patient demographics, building each care center’s new website and patient portal, and installing new hardware.
Seth says Privia provides “insanely specific” clarity on what physicians and their staffs will be responsible for doing — and what Privia will handle for them, such as creating clinical guidelines and developing population health tactics and cost reduction strategies.
Clarity on metrics and goals is equally specific. Providers, staff, scheduling, front desk and checkout teams all get training and support to help them reach ambitious targets within 30 days of their launch: 80 percent same-day encounter close rate, 30 percent patient portal adoption, 85 percent collections at time of service, 100 percent holds and missing slips completed within three days, 10 percent new patients per month, and more.
Communication is rewarded: Providers and staff are incentivized to read daily emails from Privia and monthly role-specific newsletters for updates and actions. Physicians participate in monthly meetings with their community and specialty peers, while office managers attend summits and update calls to build their skills.
“At every touchpoint, we start with all the operational things we need to accomplish for the practice,” says Seth. “Then we build in the additional items that contribute to what our medical group stands for, making sure they understand how we help provide better care to patients and reduce unnecessary costs. We can only be successful together.”
Physician engagement is a key part of the process, Seth says. The rigor of Privia’s onboarding would be unworkable if doctors weren’t willing to adapt.
“At the end of the day we’re not going to be successful if we’re just implementing a clinical and billing platform,” he says. “We have to make sure the providers we partner with have truly bought into the mission and population health journey.”
“We have lots of metrics,” says Sandy Cave, manager of data and analytics for Fairfax Family Practice, a Privia care center. “Understanding which ones are the metrics that drive change for us helps to prioritize our work and support the change in patient outcomes.”
Keeping in touch
As care centers go live, Privia’s performance consultants ensure that all staff are working to the top of their licenses. They also help to streamline workflows and review clinical and operations data, with the goal of improving outcomes and reducing costs for patients.
Gale Pryor is a senior writer for athenaInsight.