Issue link: https://beckershealthcare.uberflip.com/i/674245
39 as claims management and infrastructure. 6. Most Hospitals Must Own Practices to Thrive in the Long Run ere is no question that a health system has to own practices. If you don't own practices, your fee-for-service volume goes elsewhere. Further, if you don't own practices in the evolving managed care world, you don't have a total delivery system to provide. Part of owning practices is retaining fee- for-service volume. Another part is being able to offer integrated packages of services. Finally, part of owning practices is maintaining dominance in an area so payers and patients are unable to go around you. Increasingly, we perceive that having the dominant physician network, preferably owned, is a core to success. 1. e real questions become: 2. What kind of practices to own? 3. How big a physician network do you need? 4. Where and in what specialties do you need to be great? 5. How can you manage it efficiently? In most places, you need the biggest physician network possible, you oen want productivity-driven compensation and you want to constantly improve your physician network. One may not need to break even on their physi- cian-owned network, but one needs to be close enough that the losses are not devastating to the system. Further, one has to be prepared and have contin- gency plans in place in case physician revenues drop significantly. 7. Consumer-Driven Healthcare When we first think of consumer-driven healthcare, we think of con- sumers paying for healthcare and models of patient convenience. More and more we also think of consumer healthcare as related to overall con- sumer experience. is includes: 1. Ease of access to the system electronically 2. Convenient hours and access 3. Early intervention through data and predictable analysis 4. Great human interactions 5. Transparency in pricing and outcomes One core apparent long-term solution for really reducing healthcare costs is the greater use of high deductible and similar health plans. is is a useful strategy for the great majority of day-to-day healthcare costs. On bigger ticket healthcare costs, there will be a need for more care man- agement teams and efforts to bundle, reduce and target costs. Day-to- day, however, consumer-driven plans — such as health savings accounts and high deductible plans — seem to be the best answer out there for the system as a whole to reduce costs. For a provider that relies day-to-day on ordinary care for a great per- centage of its revenues, this is concerning. e ultimate shi of costs to consumers is the best bullet for slowing the growth in healthcare costs on a substantial percentage of the dollar. Here, this is where systems need to drive patients to their lowest cost provider, allow direction to advanced practitioners versus physicians, and get better at collecting upfront since collecting from patients later is very difficult. Hence, as a basic strategy, health systems need constant internal agitation to move costs to lower points of care and constant efforts to improve billing and collections at the point of service. 8. Talent Management ere is a great friction between keeping okay talent in place versus agitating and constantly changing leadership. ere is a pace at which change can be made that doesn't overly disrupt an organization. In con- trast, if an organization is in constant change, it results in cultural chal- lenges. A leader needs to offset this concern with the cultural challenge of allowing greatness and not mediocrity to flourish in leadership posi- tions. is is a constant challenge for health systems. ere may be a cer- tain gravitational pull toward leaving things in place rather than effecting change. At the same time, organizations get stale, slow and ultimately grind in the wrong direction if they are not constantly agitating toward greatness and constantly developing and grooming leaders for different leadership positions. In some ways, business today involves a certain amount of surfing. You want to have a great a team in place and focus on core priorities, but also be able to examine new opportunities. It is less and less that any one lead- er can tell an organization, "is is where things are heading." Rather, the key is starting with a core baseline business and making sure nimble leaders are in place who can adjust as needed. There are huge differences between managing a large system and a small system. In a small system, one needs a tight executive leader- ship team, and it can be easier to assure everyone stays on the same page. In an environment where there are 100 to 200 employees, it is a lot easier to do this with a small management team that is on top of its game. Many small health systems and many small chains thrive with a great core management team of four to five "A" players and a terrific larger staff. In a small system, however, it can be harder to develop and afford the next level of talent. In contrast, if you become a bigger system, there is an institutional con- cept that becomes more important. Great people must be in the lead of the various different units throughout the system. In general, you never want more leadership positions than you have great leaders. Increasingly, this may mean you have a great leader "double-hatting." We have seen a situation where a great CFO, for example, also serves as president of the medical group. While this isn't ideal, it is far better to have a single great leader with great discipline and drive captain two units instead of two mediocre people leading two different units. n