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Clinical integration knowledge hub

Learn about the importance of implementing a successful clinical integration strategy, along with some obstacles to avoid along the way.

Can physician acquisition create an integrated care community?

Physician acquisition and the consolidations of practices have become widespread alignment strategies for health systems, with a variety of motivations: leverage payers, widen and secure a referral base, and provide affiliated physicians an easy, efficient way to send orders and receive detailed patient information. But acquisition alone does not guarantee the desired results of better rates with payers, better systems for exchanging information or a clinically integrated care community.

In fact, acquisitions can be a costly gamble. A 2011 study in the New England Journal of Medicine shows that hospitals lose $150,000 to $250,000 per year during the first three years of a physician’s employment.1

Instead, health care organizations should begin to consider creating a care community that supports clinical integration and sustainability as a means to achieve goals that demand alignment. An integrated care community can be well-positioned for adapting to new payment models, improving efficiency among providers, better profitability, and improving patient satisfaction.

Simple organization consolidation is not the easy answer. Clinical integration is “the real key to reform,” and is an effective way to expand geographic reach and scale, according to William Petasnick, past chair of the American Hospital Association. He describes clinical integration as “an effective tool for promoting innovation, enhancing quality, and aligning incentives.”2

The Advisory Board Company recently concluded that high-performing, clinically integrated medical groups share these defining characteristics:

  • Identity as a unified, physician-led network or care community
  • Use their infrastructure to enhance group performance
  • Use incentives to engage individual physicians against group goals3

 To take on these attributes, a clinically integrated care community needs good governance, where the goals and incentives of leadership and management are aligned. An important area to focus on is creating a physician-led culture of continuous quality improvement, using tools and technology to integrate information from different systems. This can keep information flowing to the right people at the optimal time, to ensure the right people are doing the right work. This flow of information also facilitates bi-directional communication between physicians and leadership, keeping frontline physicians updated on all group activities and strategic decisions, and enabling reporting and feedback up the chain of command.

Rather than build a bigger closed system through acquisition, health care organizations are far better served by strategies that embrace interoperability across and within the care community. Open platforms and exchange capabilities are the key to any care community’s ability to share clinical data with many different partners across a wide range of systems, in order to best serve patients.

1 Robert Kocher, M.D., and Nikhil R. Sahni, B.S. Hospitals’ Race to Employ Physicians – The Logic Behind a Money-Losing Proposition. New England Journal of Medicine, May 12, 2011, p. 1790.

2 William Petasnick. It’s Time to Get on with the Work at Hand, Journal of Healthcare Management, Mar/Apr 2011, p. 97.

3 The Advisory Board Company. 2011. The High-Performance Medical Group: From Aggregations of Employed Practices to an Integrated Clinical Enterprise.

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