Grover said the challenges facing all healthcare organizations are exacerbated at academic practice plans because of both structural and cultural characteristics unique to such plans. Speaking to a sympathetic crowd of largely lay administrators of academic practice plans, Grover zeroed in on the cultural issue by saying, “You all work for the smartest people in the world. And they'll tell you that everyday.”
Among the cultural characteristics at academic practice plans that inhibit their ability to meet the demands of the healthcare delivery system in a post-reform world are the fact that they're hierarchical, autonomous, competitive, controlled by experts and individualistic, according to Grover. The healthcare delivery system of the future demands the opposite of those traits to succeed, such as the ability to work collaboratively and with evidence-based medicine protocols to reduce costs, increase quality, enhance safety and improve outcomes, he said.
From a structural standpoint, academic practice plans are at a disadvantage in a number of ways beyond the personalities of the plans' physicians, Grover explained. Among them are the lack of data on costs and efficiency, poor IT capabilities, the geographic locations of the practices and the severity of illnesses of the patients they treat, he said.
“The fact is, our patients are sicker,” Grover said. “When you don't know what to do for them, you send them to us.”
Grover said payment systems that fail to recognize the unique patient base of academic practice plans will unfairly penalize such plans financially.
Yet, Grover struck an optimistic note to end his 75-minute talk.
“We'll get through it, but it will be a real challenge,” Grover said.