Operating environment challenges reflecting increased operating costs, declining reimbursement, and changing payer and consumer demands.Reimbursement by governmental and other payers has remained stagnant or declined at a time when healthcare providers are investing increasing amounts to meet operational needs, develop facilities, adopt new technology and expand services.
Providers are facing new reimbursement methods seeking to emphasize quality, cost control and responsibility. The Medicare programs decision to cease paying for services linked to so-called never events and the emergence of pay-for-performance reimbursement mechanisms place increased emphasis on transparency and healthcare provider accountability.
The number of medical school graduates has remained stagnant, while the nations population is aging and requiring more healthcare services. Younger physicians increasingly seek a reasonable work-life balance and focus on specialty rather than primary care, contributing to physician workforce challenges.
Despite short-term regulatory strategies designed to promote the adoption of interoperable EHR systems, the financial and operational burdens of EHR systems promote alignment to gain access to EHR technology, clinical integration and related care-management systems.
In the face of these trends, healthcare leaders are working hard to develop and maintain successful IDS models that can meet community healthcare needs. Round-table participants outlined several major challenges facing established and emerging IDS models, including declining reimbursement, the decline of mission-support revenue sources and increased costs. Integration is a means to consolidate reimbursement and other resources to help address uncompensated care, delivery system investment and future needs.
Participants stressed the importance of physician alignment and engagement in IDS leadership, but nearly all acknowledged that no one right leadership model exists. Many noted the importance of maintaining physician investment in day-to-day clinical practice operations. An increasing number of IDS models are promoting quality as the central theme that can lead to ancillary improvements in patient satisfaction, efficiency and effectiveness.
One of the perceived benefits of integration is the ability to access capital for the benefit of the IDS and the communities served in light of limited resources in todays financial environment. IDS models place increased emphasis on the development and refinement of compensation plans that are market competitive, promote physician recruitment and retention, and align performance with near- and long-term goals. Many round-table attendees used the program to network with peers to identify best practices and trends in physician compensation and alignment strategies.
Today many individual physicians view established and emerging integrated systems as desirable settings for the practice of medicinea fact that creates its own strategic and operational challenges. Many round-table attendees highlighted the operational, managerial and other challenges created by increased integration. Many IDS models are working to determine the right size and provider complement, questioning whether and how they can absorb additional physician practices, and striving to stay ahead of the curve in developing EHR systems and operational infrastructure in times of rapid growth and change.
Integration is a national trend, but the mechanics of making IDS models work must be addressed locally. Nevertheless, health system leaders benefit from opportunities such as the round table to share their experiences, best practices, trials and tribulations with peers as they work to advance successful integration in their markets.