Healthcare Executives Weigh In On Physician Alignment At Huron Healthcare's Annual CEO Forum

Hospital Leaders Share Strategies for Aligning Physicians Around a Value-Based Mission

Huron Consulting Group, a leading provider of business consulting services, released additional insights from its third annual Huron Healthcare CEO Forum. Hospital leaders at the Forum agreed that physician alignment – ensuring that physicians are contributing to meet clinical, patient satisfaction, and economic goals – is crucial for thriving under value-based payment models.

“Innovations around economic and clinical alignment across the entire continuum of care – the hospital and physician, the inpatient and outpatient, the acute, post-acute – are underway, and they are essential for success,” said Andrew A. Ziskind, managing director and Clinical solutions leader, Huron Healthcare.

The task of achieving alignment can be especially difficult in acquired physician practices. “Creating optimal alignment between a hospital or health system and acquired physician practices is a major challenge,” said Curt B. Whelan, managing director, Huron Healthcare. “However, by taking a proactive approach – and being prepared to have crucial conversations before, during, and after an acquisition – hospitals, physician practices, health systems and acquired physicians alike can build collaborative, collegial relationships that benefit all stakeholders, especially patients.”

Discussions at the Forum explored five key strategies on achieving physician alignment:

1) Shifting Physician Perspectives
To provide the clinical leadership hospitals need in a value-based payment model, physicians need to connect their day-to-day clinical decisions with the big picture imperatives of doing better with less. However, this shift in perspective can be difficult for physicians to make.

“Every day I am emphasizing the bigger picture with physician groups,” said Michael J. Dowling, President and CEO, North Shore-LIJ Health System. “Some physicians in leadership positions have trouble getting the bigger picture about the system as a whole. It’s so immense and so complicated we have to communicate about it. It can be very hard for them to be collaborative enough and tough enough with their peers to do what they need to do. However, they are ideal partners, because when they get it, changes are supported.”

2) New Approaches to Physician Hiring and Recruitment
Several CEOs emphasized that getting recruiting and hiring right is the first step to ensuring optimal stakeholder alignment.

“Alignment begins with the job interview,” said Chris D. Constantino, Executive Director, Elmhurst Hospital Center. “We have to be able to talk about what is valued in our culture, what is tolerated, what is not tolerated.”

3) Evolving Organizational Structures
Many executives discussed ways they have changed their organizational structure and incentives to support better alignment.

The dyad model, in which a physician and administrator are paired, was a frequently cited approach for helping to achieve physician alignment. The goal of the dyad model is to balance clinical and operational expertise.

“We went to a dyad model and spent a lot of time getting physician leaders educated and trained—because great medicine skills don’t necessarily translate to great leadership skills,” said Mark Laney, President and CEO, Heartland Health. “It’s not cheap; however it’s less expensive for the organization in the long run than not doing it. Both members of our dyads have identical goals and incentive bonus opportunities—they sink or swim together. Each dyad is unique. It’s kind of like a marriage. They have to decide how they’re going to work together, and how they’re going to gain consensus.”

4) Re-Thinking Physician Compensation
The CEOs addressed the ways compensation approaches are evolving as payment models change.

“Having a compensation strategy that supports physician alignment is key,” said Michael J. Dowling, President and CEO, North Shore-LIJ Health System. “Physicians want economic protection as they change how to do business in the new environment.”

Many CEOs with employed physicians have moved beyond using productivity as the sole or primary compensation driver, incorporating additional metrics that reward increased levels of engagement, among other incentives.

“Our contracts have requirements around patient face time and productivity,” said William Atkinson, President and CEO, WakeMed Health & Hospitals. “We have lost some physicians who didn’t agree with or couldn’t meet our guidelines.”

5) Deepening Physician Engagement
In addition to restructuring physician compensation, many CEOs are looking at new strategies to motivate and engage physicians.

“We are using a tool to measure physician engagement and what motivates them,” said M. Michelle Hood, President and CEO, Eastern Maine Healthcare Systems. “Setting targets – but not micro-managing – and helping them get where they need to go is very important. We have also been looking very closely at how we can incorporate physicians’ ‘hierarchy of needs’ into our approach.”

Attendees at the Huron Healthcare CEO Forum represented a broad range of organizations, from larger multi-hospital systems to academic medical centers to smaller community hospitals, and across urban and rural communities. Huron Healthcare’s CEO Forum report also shares additional valuable insights on transformative leadership and innovation from the attendees. Key themes highlighted in the report include:

• Priorities: Leading Through Disruptive Innovation to Make Organizational Change Real
• People: Achieving True Alignment with Key Stakeholders  
• Patients: New Approaches to Care Delivery and Patient Relationships
• Purpose: Leading and Engaging Stakeholders

Inventing the Future of Healthcare: Top CEOs on the Real Work of Transforming the Healthcare Industry, Insights from the Huron Healthcare CEO Forum is available for download at www.HealthcareCEOForum.com.

About Huron Healthcare
Huron Healthcare partners with clients to provide comprehensive performance improvement solutions that improve quality, increase revenue, reduce expenses, and increase physician, patient, and employee satisfaction across the healthcare enterprise. Clients include national and regional integrated healthcare systems, leading academic medical centers, community hospitals and physician practices. Modern Healthcare ranked Huron Healthcare third on its 2012 list of the largest healthcare management consulting firms. For more information, visit www.huronconsultinggroup.com/healthcare

About Huron Consulting Group
Huron Consulting Group helps clients in diverse industries improve performance, comply with complex regulations, reduce costs, recover from distress, leverage technology, and stimulate growth. The Company teams with its clients to deliver sustainable and measurable results. Huron provides services to a wide variety of both financially sound and distressed organizations, including healthcare organizations, Fortune 500 companies, leading academic institutions, medium-sized businesses, and the law firms that represent these various organizations. For more information, visit www.huronconsultinggroup.com.