A growing number of physician practices are consolidating, and more individual physicians are joining health systems.1 For the first time ever, less than half of US physicians—47 percent—own their practices. While physician consolidation is nothing new, this time around it appears to be driven by the need to improve patient outcomes while reducing costs. This emphasis on value and affordability fundamentally distinguishes today's consolidation from prior years and is causing many health systems to rethink how they work with physicians.
In the early 1990s, hospitals and integrated delivery networks acquired physician practices primarily to capture new or protect existing market share for inpatient services. Many of those organizations subsequently lost money, divested, and exited the business of practice management.2
Today, affiliating with a larger organization can help physicians reduce financial and regulatory risk, and gain access to the resources and capabilities they otherwise would not be able to build or buy, according to Deloitte's 2016 Survey of US Physicians.3 Being part of a larger organization also can enable physicians to practice population health under value-based care contracts.
To better understand what health systems are doing to successfully align with physicians to deliver affordable, high-quality care, the Deloitte Center for Health Solutions interviewed 28 executives in leadership roles at health systems and large physician groups.
We found that embracing value can be a challenging cultural change. As health systems shift their focus from volume to value, they should concurrently address quality, affordability, and revenue objectives. Sharing data and savings with physicians could be essential to making this work. Our research uncovered other strategies that can help, such as surrounding physicians with resources for care management, quality improvement, and operational efficiencies, and aligning compensation approaches and quality metrics with those used by major health plans.
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) could serve as an accelerator in these efforts. MACRA may offer a framework for health systems, physicians, and health plans to standardize approaches for evaluating physician performance on quality and value.
Executives we interviewed agree that six strategies can strengthen the alignment between health systems and the employed and/or independent physicians they work with:
- Know your partners
- Put physicians in charge
- Support data-driven decisions
- Make it worth their while
- Be transparent
- Provide the tools for success
To learn more about the steps you can take to achieve better physician alignment, download the full report.
Read more in: Six physician alignment strategies for health systems.
Footnotes
- Alex Kacik, “For the first time ever, less than half of physicians are independent,” Modern Healthcare, May 31, 2017, http://www.modernhealthcare.com/article/20170531/NEWS/170539971, accessed September 20, 2017.
- Law360, “Hospital employment of physicians is coming back,” March 18, 2008, https://www.law360.com/health/articles/50494/hospital-employment-of-physicians-is-coming-back, accessed September 20, 2017.
- Deloitte Center for Health Solutions, Are physicians ready for MACRA and its changes? Perspectives from the Deloitte Center for Health Solutions 2016 Survey of US Physicians, https://www2.deloitte.com/content/dam/Deloitte/us/Documents/life-sciences-health-care/us-lshc-are-physicians-ready-MACRA.pdf, accessed September 20, 2017.
