Physician Alignment: Constructing Viable Roadmaps for the Future PDF

Preface

We hope you will agree after reading Chapters 1 and 2 that our current path in healthcare is unsustainable. Clearly, there is an unlimited demand for limited healthcare resources. With our current aging population and technology advancements, we cannot possibly keep using our current broken and fragmented healthcare models. As healthcare leaders, we can play an active role at the local or regional level in strategies that increase value and maximize the use of healthcare resources. To do so will require new thinking.

After a long wait, the Supreme Court upheld the Patient Protection and Affordable Care Act (PPACA). Somewhat unexpectedly, the entire healthcare law was upheld in its entirety. It is difficult to predict what will occur in the future as we move toward a defining presidential election. Regardless, there has already been significant impact in many areas of healthcare, including within most healthcare organizations. The underlying premise that healthcare is just too expensive, with an increasing trend that is unsustainable, is not changed or altered by healthcare reform efforts, legislation, or the fact that the Supreme Court upheld the law. The increasing trends in the overall cost of healthcare are becoming unsustainable. There is simply not enough funding to maintain current healthcare spending without significant sacrifice of other critical needs.

This book is written for a broad group of audiences. It is meant to be an introductory primer on looking at healthcare delivery models and various types of integration. The audiences should include physician executives, physicians who are in practice looking at alignment, hospital administrators, and anyone who is involved in the healthcare delivery system. The articles covered in this book should affect everyone who is involved in healthcare.

The book starts setting the stage with Chapters 1 and 2 with an overview of the current trends in healthcare and why change is inevitable. We hope we make this argument compelling.

The next chapters focus on the different types of integration. While we do not go into any detail on some items, we start with the simplest types of integration (i.e., medical staff and medical directorships). We evolve quickly into full employment models with full integration. The last chapter tries to tie these together, bringing up all the other critically necessary factors for full integration, including patient engagement, information technology (IT) solutions, and others.

This book is not meant to be a guidebook or how-to-do-it book but as a means to set the stage to get people thinking about and understanding the various intricacies of integration. Each local market is different and subject to a different speed of change. It is often said that healthcare is always local, and we believe that is true. So, understanding the local market, politics, delivery systems, and legal environment becomes a critical factor in deciding what the right strategy for a particular system is.

In the long term, a full solution is much more complicated than simply physician and hospital integration. The entire healthcare system must be integrated in a meaningful way. This would include

• Full vertical and horizontal integration.

• Complete data sharing across the system. This includes clinical, cost data, and medical decision support.

• Complete transparency.

• Patient advocacy (one of the biggest challenges).

• Complete knowledge

• Transparency so patients understand the risks and benefits of any medical decision making.

Making this happen is a tall order and very complex, but we hope this book will help in your thinking process. This journey is going to be a bumpy road for the next several years but we hope it will end in a smooth landing after we get past the turbulence.