Becker's Hospital Review

20 Executive Briefing: Clinical Integration Sponsored by: What it Takes to Build a High Performing Medical Group A s traditional models of healthcare delivery continue to undergo rapid upheaval, hospitals and health sys- tems must adjust. Critical to their success is the ability to operate as a high perform- ing medical group. The Health Care Advi- sory Board defines high performing medical groups as "organizations that have generat- ed strong results by fostering a commitment to mutual success among physicians." 1 A high performing medical group improves care coordination, engages patients and develops provider loyalty — all while im- proving quality and reducing costs, essen- tial in the move to population management. But, how do you build a high performing medical group, and what critical elements must be in place? Why build a high performing medical group? Hospitals and health systems are currently experiencing a migration in care, with vol- ume shifting from inpatient to outpatient. As a response to this and other market changes, organizations have relied on aggressive acquisition strategies to grow their physician ranks — yet many continue to manage practices as stand-alone units, believing that physicians prefer a "hands- off" management style. Because physicians play a critical and direct role in any health care enterprise's financial health (one study points out that physician orders are "directly responsible for 80 percent of [healthcare] spending." 2 ), the "hands-off" approach is problematic. It fails to capture the potential benefits of operating as an integrated organization: an expanded referral network, enhanced patient access, operational economies of scale, opportunities to improve quality and better care coordination. With rising costs, changing payment mod- els and patients seeking care in more var- ied settings, health system leaders are carefully reconsidering how their organiza- tions can optimize productivity and perfor- mance— especially when needing to align large groups of acquired physicians. Creating a high performing medical group can help health care organizations: • Prepare for future payment models in a changing reimbursement environment; • Manage the transition toward more integrated care delivery; • Manage growth and productivity with a meaningful connection to employed and affiliated physicians; • Better serve patient populations with increasingly patient-centric models of care delivery and management; and • Meet the requirements of evolving clinical quality standards. The right foundation Managing the transformation of a dispa- rate collection of caregivers into a cohe- sive, integrated, aligned group can rep- resent a major investment. To ensure a smooth transition, organizations need the right foundation: communication and IT in- frastructure that provides maximum influ- ence and control over performance, while supporting strategic goals and profitability. Today, there are generally three approach- es to IT: • insourced solutions, or software- server models, where the medical center owns and runs the software and system infrastructure • Fully or partially outsourced solu- tions, where the software lives on the vendor's system • Cloud-based services, a combina- tion of software, data and intelligence that's hosted and managed on the web, where users can securely ac- cess continually updated informa- tion. With one such cloud model, called a "co-sourcing" solution, the IT vendor performs work on the health system's behalf to complement work performed by the organization's staff. When all factors are considered, a co- sourced, cloud-based services solution is the only HIT offering that can deliver health systems a favorable total cost of "owner- ship." The cloud platform is already seeing widespread acceptance as healthcare pro- viders' choice — a KLAS report found that 71 percent of providers were deploying or planned to deploy cloud technology. 3 Comparing iT Models Cloud insourced Outsourced Implementation Cost Low High Low Visibility Into Enterprise High High (with additional cost) Low Control Over Workflow High Low Low Flexibility in Evolving Reimbursement Environment High Low High (with additional cost) Scalability High Low High lower cost, greater visibility and connection to outcomes Higher cost, lower visibility, and no connection to outcomes We connect care. So outreach is automated and care managers can focus on the sickest patients. So patients enjoy a seamless care experience across your health system. So referrals go to in-network specialists with the information they need. So health system leaders can connect actions to results: More revenue. Better quality. Loyal patients and physicians. Patient Primary Care Physician In-network Specialist Cloud-based EHR, practice management and care coordination services Proud to be an Offi cial Sponsor of the 5 th Annual Becker's Hospital Review Meeting Find out how our Best in KLAS services can help you connect across the continuum of care. * "2013 Best in KLAS Awards: Software & Services," January, 2014. © 2014 KLAS Enterprises, LLC. All rights reserved. www.KLASresearch.com

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