Becker's Hospital Review

42 Executive Roundtable Sponsored by: Redefining the Hospital-Physician Relationship: How Integration is Evolving for Success Under Value-Based Reimbursement T he healthcare ecosystem's shift to value — helped along by programs like the Medicare Access and CHIP Reautho- rization Act and the Merit-Based Incentive Payment Sys- tem, bundled payment demonstrations and commercial payer reforms — requires hospitals and physicians to redefine their relationship. As reimbursements continue to decline and administrative re- quirements increase, physicians want healthcare organizations to help provide a more stable infrastructure to support new payment models so they can focus on patients. Meanwhile, hospitals are relying on the performance of physicians on the frontlines for financial security, given that reimbursement and incentives are directly linked to quality performance and pa- tient outcomes. To put it simply, in an era of value-based reimbursement, phy- sicians and hospitals need each other. And they need to inte- grate in new ways to succeed in this emerging model. Successful integration requires hospitals and physicians to re- think how they report and use quality and cost metrics. It re- quires new financial relationships and contracts, and it calls for restructuring of leadership and governance. Becker's Hospital Review caught up with finance leaders from two distinct healthcare organizations — a specialty cancer cen- ter and a health system — to discuss how they are approaching this shift and how the move to value-based care is redefining the hospital-physician relationship. Participants include: • Joanna Weiss, Vice President of Revenue Cycle Manage- ment at Moffitt Cancer Center (Tampa, Fla.) • Jon E. Riggs, Senior Vice President & CFO of Medical Cen- ter Health System/MCH ProCare (Odessa, Texas) Editor's note: Responses have been edited lightly for length and style. Question: What are employed physician groups looking for from their hospital (i.e. aligned incentives, shared infra- structure, regulatory compliance, increased transparency around payer contracts/negotiations, etc.)? Joanna Weiss: Our physicians are looking for their hospitals to make their jobs more efficient and to reduce physician burn- out. Those are two top-of-mind topics that continue to come up from our physician groups — how can we make our EHR more efficient for the physician and how can we lighten the adminis- trative burden, so they can concentrate on seeing their patients. Our physicians are a little more unique than other groups be- cause they are in academia. Their focus is research, their aca- demic interests and their clinical interests. The advancement of new therapies and innovative care is promising. As a result, they really rely on administrative folks to find ways to improve reimbursement for the care they provide. There are pockets of physician administrators that are looking for creative reim- bursement models. Jon Riggs: In my opinion, physicians are looking for a con- sistent paycheck in a time of decreasing reimbursements, in- creased regulatory responsibility and increased audit recoup- ment. They are also facing incentive-based reimbursement. That means they will potentially receive lower reimbursement if they have to rely on patient compliance. Q: What do hospitals/health systems want from their physi- cian group to achieve and sustain organization-wide finan- cial health and clinical goals (i.e. adherence to reporting processes, increased quality standards, cost containment, etc.)? JW: We are looking for our physicians to document their care in a timely fashion, to provide access in the consumer-driven market and continue to reduce time to treatment, which is ul- timately going to support our goal of better patient outcomes. "[P]hysicians are looking for a consistent paycheck in a time of decreasing reimbursements, increased regulatory responsibility and increased audit recoupment." — Jon Riggs, Senior Vice President & CFO, Medical Center Health System/MCH ProCare

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