Efficiently Onboarding Physicians: 6 Strategies

November 7, 2014
Michael Lovett

Here are six strategies to help practices and hospitals come together whether they are seeking to merge operations or simply enhance their working relationship.

To meet the challenges of today's rapidly changing healthcare environment, hospitals and health systems are acquiring physician practices at a record pace. While this strategy offers many benefits, it is not without its hurdles. For example, it can be difficult to get physicians fully integrated with current organizational processes and culture. Roadblocks, such as disparate work flows, diverse practice styles, and a tendency toward physician autonomy can stand in the way of smooth onboarding, impacting the speed of the effort as well as overall practice efficiency.

To fully realize the benefits of a new partnership, physicians and acquiring organizations must work together to overcome any challenges early in the relationship in order to sustain high levels of care quality and patient satisfaction while also improving business operations.

The following strategies offer healthcare organizations a roadmap for getting newly acquired providers up to speed and supporting greater collaboration as the organization grows and changes.

Check Goal Alignment

Before moving forward with a merger or acquisition, it is imperative that both the practice and hospital have the same vision for the new partnership. For example, if a hospital's pragmatic strategy to avoid risk does not fully align with a physician's idealistic goal of improving healthcare delivery throughout the community, then this mismatch could mean a less-than-effective relationship. Defining strategic goals, the model of care and the role of each party upfront strengthens the connection from the start.

Collaborate to Create Wins for Both Sides

As with any business acquisition, it is important to gauge each party's strengths and weaknesses and build on assets while mitigating limitations to create an effective organization. For instance, a mid-sized practice may be highly skilled at personalized care delivery but lack the resources to implement a robust information technology infrastructure, an area in which the hospital is highly skilled. When both sides remain open to resource sharing and other collaboration-enhancing opportunities, the total organization stands to benefit.

Embrace Flexibility

When joining a health system, a practice should expect to lose some degree of autonomy as technology and business systems become integrated. However, hospitals must refrain from simply requiring physician practices to use the hospital's clinical and financial systems. Instead, the acquiring organization should take a best of breed approach, ensuring specialty practices have the technology best suited to their clinical needs. This technology must also integrate well with hospital solutions to support information sharing across the continuum.

Involve Physicians in Decision Making

The change management necessary to merge a medical practice with a hospital or health system is much easier when physicians are involved in the decisions that impact the practice and the community. Physician engagement early and often is paramount to ensuring physicians feel welcomed into the organization. It also helps garner buy-in for organization-wide strategies, improves communications across the continuum, and creates synergy for the broader organization. For example, a monthly meeting between employed physicians and the hospital or healthcare system can increase dialogue between physicians and administrators and identify areas of improvement or future needs for both parties. Small physician focus groups can also be beneficial, especially when considering technology and infrastructure changes that will directly support physicians' practices and enable better work flow.

Develop a Technology Plan

Organizations that take time to craft a technology plan, which takes into account both hospital and physician needs, can find it easier to get everyone on board with new systems. Both practice physicians and hospital physicians should be involved in creating and revising this plan. Technology decisions should be driven by a platform's ease of use across the entire organization and, more importantly, how it seamlessly enables both groups of physicians to get the information they need to effectively manage patient outcomes.

Establish Metrics to Assess Progress

Onboarding should be a continuous process in which hospitals and practices regularly capture, report, and analyze information that reflects the evolving relationship. These measures should be defined upfront and take into consideration organizational goals, regulatory requirements, performance indicators, and so on. Before reporting on metrics, organizations should make sure that everyone clearly understands the data being gathered, how it will be reported, and the desired outcomes. The organization should also have a defined process for course correction if the data shows a less than optimal result.

Consider some of the following logical metrics to measure:

• Financial metrics
 
If this new relationship is based on financial drivers, define the most important ones, such as Medicare billings per month, overall practice cash flow per month, or payer mix measurement.

• Patient outcomes metrics
If the long-term goal is to improve patient care throughout the community, various measures such as the HEDIS Effectiveness of Preventative Care or the Effectiveness of Chronic Care can be assessed. These will also cross over into the financial view if the organization is moving toward outcomes-based reimbursement contracts. Another consideration includes ensuring that all parties really understand how these measures are derived and what they mean for the organization's success.

• Productivity metrics
Sometimes considered a "third-rail" topic, measuring productivity is critical to gain - and maintain - alignment. Productivity is often measured by how many patients a provider sees in a given day or how many admissions the practice is sending to a hospital. The more important aspect, however, is to remain patient-focused. The new relationship between hospital / health system and the practice should help the provider to care for his patients in an efficient manner.

Michael Lovett is the executive vice president and general manager at NextGen Healthcare. Follow him on Twitter.