Becker's Hospital Review

33 Clinical Integration & ACOs Boeing to Contract With Providence- Swedish, UW ACOs for Employees By Molly Gamble B oeing selected two Seattle-based accountable care organi- zations — one affiliated with Providence Health & Services and Swedish Health Services, the other with UW Medicine — for its new Preferred Partnership option for employees. Beginning this fall, 27,000 Boeing employees in the Puget Sound area and about 3,00 retirees can choose either ACO for their per- sonal and family health plans, according to a Seattle Times report. The plans take effect Jan. 1, 2015. Providence-Swedish Health Alliance includes the network's clinics and hospitals, as well as The Everett Clinic, Pacific Medical Centers clinics, The Polyclinic, Proliance Surgeons and other care settings. Members of the UW Medicine network include Seattle Children's Hospital, Seattle Cancer Care Alliance and the Overlake and North- west Hospital centers and clinics, according to the report. Boeing officials say there are numerous incentives for using the Preferred Partnership option, including lower paycheck deductions to pay for care, larger company contributions to health savings ac- counts, no co-payments for visiting primary care doctors in many cases and 100-percent coverage for generic drug prescriptions. n Dr. Farzad Mostashari Launches Startup to Help Independent Physicians Form ACOs By Helen Gregg F arzad Mostashari, MD, the former National Coordinator for Health IT, has launched a new company designed to help independent pri- mary care physicians form and join accountable care organizations. The startup, called Aledade, aims to provide physician clients an afford- able way to access all the tools necessary to create an ACO, from consulting services to capital loans to new technology. The company does not charge an up-front fee, but rather takes a 40 percent cut of the savings realized through the ACO. In the launch announcement, Dr. Mostashari said his work with the ONC promoting the adoption of health IT was about giving providers the neces- sary tools to improve care delivery — a goal his new company shares. "For me, health IT was never the 'ends,' but a 'means' to better health and better care," he wrote. "Empowering doctors on the frontlines of medicine with cutting edge technology that helps them understand and improve the health of all their patients — that is the mission of our new company, and one that has animated my entire career." Aledade's leadership team also includes former ONC official Mat Kendall, who in March resigned his post as the department's regional extension cen- ter chief. Aledade is backed by health IT venture capital firm Venrock. n 4. Non-compete/termination A wise attorney once told me it is important to draw up the divorce papers with the marriage documents. I believe this same principle applies to a well-written physician employment contract. Many of these contracts will include a restriction on the practice of medicine upon the termination or expiration of the contract. In most cases, there is a restriction placed for a certain number of years and a certain distance from the hospital (e.g., two years and 30 miles). Two areas of concern, beyond the obvious time and distance restrictions above, are when the re- striction applies, and also to what locations it ap- plies. If the health system has multiple locations, you will need to limit the language to provide that only the locations serviced by the physician are in- cluded in the non-compete. Also, in the event the employer terminates the physician without cause, or if the employer is in breach of contract, the non-compete should be non-applicable. Here is an example of how a poorly worded non- compete can make life difficult. Imagine a physician joined a practice out of resi- dency and started work on Aug. 1, 2013. On Aug. 4, 2013, the CEO of the practice came to the group and said, "we have just been sold to another health system, and you will all be receiving a new con- tract." The new contracts paid the physicians less, and they took call more. The physician refused to sign the new contract and was terminated without cause on Aug. 6, 2013. However, because the non- compete in her initial contract applied regardless of how the contract was terminated, she was pre- vented from practicing in the area after she had just moved her family to the city — all after five days on the job. 5. Compensation The most common compensation structure for employed physicians will include a base salary with productivity and quality bonuses attached to physician performance. Productivity bonuses can be structured based upon billings, collections or wRVUs. All three structures have positives and negatives attached and should be fully understood by the physician. Fairness and accurate comparisons are the con- cepts to consider when discussing compensation. When comparing opportunities, the position with the highest base salary may not be the most ben- eficial compensation package. A detailed analysis of the productivity and quality bonuses should be done to ensure that bonus thresholds are set ap- propriately and that the numbers are fair when compared with third party compensation surveys such as MGMA. n Sidney Christiansen, MD, has spent the last 30 years as a practicing otolaryngologist in both private and academic sectors, and after retiring, founded Resolve Physician Agency to educate and prepare other phy- sicians on the business side of medicine.

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