six physicians alignments digital pic


Six physician alignment strategies for health systems

Key findings from interviews with US health system executives

​New technology, a complex regulatory environment, and the quest for affordability make health care provider consolidation much different than it was 20 years ago. Explore six strategies to help hospitals and physicians achieve better alignment and meet their value-based care goals.

Consolidation versus collaboration

There's no question that the number of small, independent physician practices is shrinking. Many physicians are consolidating to stay financially afloat, meet regulatory requirements, negotiate complex value-based contracts with health plans, and access capital for expensive health information technology (HIT) and reporting investments.

Consolidation could indeed be the future. But what does that mean? To some, consolidation is just another term for mergers and acquisitions (M&A). But physician consolidation extends beyond M&A to encompass a wide range of strategies in which physicians band together or integrate clinically and financially with other stakeholders—from employed groups to independent practice associations to clinically integrated networks and more—that align with health systems and health plans. Consolidation also means that health systems need a playbook for collaborating with physicians.

To gain insight into how health systems and physician groups work with their physicians, the Deloitte Center for Health Solutions interviewed 28 executives from 26 health systems and large physician groups. We also spoke with professional associations and organizations that serve both health systems and physicians.

Health system checklist: Operationalizing value and partnering with physicians

*Click to enlarge image

The six strategies

Since alignment occurs when patient care and financial goals are shared between a health system and its physicians, the strategy for achieving those goals should be developed collaboratively.

To succeed in the value-based care environment, the executives we interviewed concur that health systems and physicians should pursue the same goals: superior outcomes, lower costs, and positive patient experiences. Employing the following six strategies (which are also showcased in the graphic above) may aid in hospital-physician alignment and collaboration:

  1. Know your partners
  2. Put physicians in charge
  3. Support data-driven decisions
  4. Make it worth their while
  5. Be transparent
  6. Provide the tools for success

Health systems recognize that physicians are critical to value-based care and population health efforts.

Developing a plan

Surrounding physicians with the right resources for care management, quality improvement, compliance, and operational efficiencies is a work in progress. For many health systems, doing so will require additional investments in people, resources, and technology. To prioritize these investments, health systems should partner with physicians to assess their current operational and clinical needs and their organization's position compared to leading industry practices.

We heard from our executive interviews that top strategies apply regardless of the type of physician affiliation, employment, or alignment model. Crafting an effective physician alignment strategy requires a thorough evaluation of a health system's operating model, market presence, and clinical and support capabilities, as well as a procedural review that goes beyond compensation.

Questions to ask may include the following:

  • Have we engaged with the right physicians, in the right locations, with the right performance levels?
  • Do we have an adequate mix of primary care providers and specialists to effectively coordinate care and manage costs for our patient populations?
  • Can current capacity keep up with population dynamics, patient access, and market demands?
  • How does our physician network compare to that of our competitors on cost, quality, and market positioning?
  • Do we have the right care navigation and steerage patterns to meet patients' needs and support our clinical strategy?
  • How are traditional and nontraditional competitors in our market engaging with physicians?
  • Are there efficiencies to be gained with our ambulatory services footprint through consolidation or reconfiguration?

To learn more about the steps you can take to achieve better physician alignment, download the full report.

“Employed or independent, you need to align incentives somehow.”

—CMO, large medical group

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