Slightly more than half of all hospitals conduct profiles of physician practices, and less than 40% of institutions hold physician department chiefs financially accountable, according to preliminary findings of a new survey.
Results of the survey, which aims to find the link between hospitals' fiscal health and the nature of their relationship with physicians, were released at a meeting last week of the Prospective Payment Assessment Commission, a panel that advises Congress on Medicare payment issues.
ProPAC Chairman Stuart Altman said the research effort was launched after complaints by hospital executives that their institutions were frequent targets of federal payment cuts, despite the fact that their costs were largely dependent on physicians' treatment decisions.
While ProPAC continues to analyze survey results, it hopes to eventually show whether hospitals with physicians "who see themselves as part of a team" fare better, Mr. Altman said.
To assess the quality of relations between hospitals and physicians, ProPAC surveyed chief executive officers and chiefs of medical staffs at 2,200 hospitals nationwide. The survey sought to measure the extent of joint-venture activity and physician profiling, which Mr. Altman said were good reflections of hospitals' and physicians' willingness to work together. Respondents also were asked for their opinions about who has the most control over management decisions and the extent of information sharing.
More than 87% of CEOs said physicians were involved in the hospitals' budgetary process, and 72% said they shared financial data with physicians. But only 48% said they shared clinical financial data, and just 41.2% said they told physicians the price of ancillary services. In addition, only 39.9% said they held hospital department heads financially accountable for their part of operations.
Overall, only 52% of CEOs said they profiled physicians' practices for patterns of procedures that are relevant to hospital performance. Of those that did profile physicians, 91% included the volume of services, 79.4% looked at length of stay and 84% examined quality of care in the profiles. But just 41% of the profiles included physicians' use of ancillary services, only 36% looked at hospital revenues per admission and just 32% profiled hospitals' cost per admission.