Issue link: https://beckershealthcare.uberflip.com/i/613323
22 PRACTICE MANAGEMENT the patient's entire care experience. "What we value is whether physicians make great decisions, learned decisions and whether the patient has a great experience," said Dr. Murrey. "at's an inward way of looking at the world. If I'm a systems thinker, I look at the world differently. How many physicians ordered tests that haven't been done? e patient cares less about whether you made the good decision to order the test than whether they got what they needed. If I'm outside the system as a private practice physician, am I asked to take responsibility for what happens inside the system? I can't just send my patients with an order out the door. I have to take responsibility to make sure the patient gets what is needed. is is a move from autonomy to accountability." e healthcare system is currently mired with misaligned financial incentives — rewarding work done, not health improvement — and poor communication. ere isn't transparent pricing and poor connectivity between providers can lead to a lousy patient experience. Care oen isn't coordinated intuitively for patients. "Unbridled autonomy and the lack of integration and coordination in healthcare is provider-focused, not patient- focused," said Dr. Murrey. "Clearly, we need a systems approach to address these issues. e demands of complexity and efficiency require scale to afford it." Solo practitioners oen don't have the resources to purchase an EMR for benchmarking and data gathering. ey aren't able to communicate with other providers in a meaningful way without this technology, and the infrastructure becomes overwhelming. e larger scale groups enable transparency and accountability in healthcare for a disciplined approach. "At OrthoCarolina, our culture is built on quality, service, community and teamwork. If you have physicians emboldened for higher quality at a lower cost, the market should reward you with value-based contracting, ACOs and bundled payments," said Dr. Murrey. "You should know how your group compares with other groups around the country and begin to take on risk. We do take risk on ourselves with seven commercial bundle relationships in mostly hips and knees, but some in spine." e bundled payments have been a transformative opportunity for OrthoCarolina physicians to work with patients; the readmissions and complications are minimized. Every patient goes home by a day-and-a-half aer surgery and their patients report good numbers on the pain scale. "is is a process that allows us to provide better care for patients at a lower cost," said Dr. Murrey. "Ultimately the platform that will allow you to meet those requirements is the right culture and shared decision-making. Choose a strategy you can perform on; strategy is great, but it must be rooted in your organization's culture." n