Hospitals and physician groups often partner with one another in order to save money and improve clinical results. However, not many are successful in documenting reductions in costs.
So says Sally Luaces, practice leader for operations redesign at Trenton, N.J.-based McFaul and Lyons Group, a unit of Johnson & Johnson Health Care Systems.
In a HFMA session titled "Partnering with Your Physicians: Improve Clinical and Financial Outcomes," set for 8 to 11: 30 a.m. Wednesday, June 23, Luaces and Mary Ellen Rauner, senior consultant with the group, will discuss tactics and tools that lead to successful partnerships.
Having strong physician champions is an essential key to creating change. "Nobody can tell a physician how to practice except other physicians," Luaces says. "Those physicians are driving this change process. They own it."
In addition to developing strong physician leadership, hospitals need to gather updated, severity-adjusted data documenting physician-specific spending in areas such as pharmaceuticals, laboratory procedures and radiology. Physician leaders then need to analyze the data and bring the department chairs together to discuss variances in their practices and brainstorm ways to bring them in line.
"Physicians will come to the table and will talk if you have data they think is correct and is related to them," Luaces says. "With peer-to-peer conversation and interaction, you can bring the doctors together to produce change."
Physicians and hospital administrators may realize that the doctor with the highest cost associated with his or her particular field also has a high readmission rate, Luaces says. "High cost doesn't always mean high quality, and low cost doesn't mean low quality," she says.
In addition, hospitals should measure patient satisfaction and clinical quality in terms of readmission rates and mortality and compile the information in a physician report card.
"Physicians should get regular feedback on how they're doing," Luaces says.
A successful program should achieve reduction in costs associated with patient care, she says. Physicians will be able to decrease readmission rates, control length of stay and reduce denied days by managed-care plans. Successful programs also don't damage quality of care or patient satisfaction.
Physician leaders and hospital administrators should also develop a shared culture and vision early in the relationship, Luaces says.
"When there is an appropriate change in the hospital culture, physicians' clinical behavior should start to change," she says. "Physicians should recognize that cost is key to the way they should operate in the hospital."