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47 Executive Briefing Premier Inc. is a leading healthcare improvement company uniting an alliance of approximately 3,750 U.S. hospitals and 130,000 other providers to transform healthcare. Premier is passionate about transforming American healthcare and plays a critical role in the rapidly evolving healthcare industry, collaborating with members to co-develop long-term innovations that reinvent and improve the way care is delivered to patients nationwide. "As health systems grow and acquire new hospitals and physician groups, new operating models must also be deployed to support the coordination of care across the whole system," said Mr. Smedley. Physician committees, or teams of multispecialty clinicians, are an effective model to maintain accountability as new providers join the ranks. "Team-wide accountability is impossible if only affiliated physicians are integrated into cost-containment and outcome improvement strategies. Successful physician committees embrace stakeholders from both employed and nonemployed physician groups and foster productive communication and buy-in between physicians on the frontline, regardless of affiliation," Mr. Smedley said. Dyad leadership models and diverse physician committees strengthen administrative and clinical accountability and keep the focus on patients and their journey through the system as hospitals navigate quality improvement and cost-cutting initiatives. However, it is short-sighted to say hospitals are in the clear after implementing these new accountability models. The work has only just begun — hospitals must now track and leverage trusted physician performance data to ensure their organization is functioning as a sustainable, integrated delivery network. Driving progress with data: 5 critical steps To effectively gain physician buy-in and promote clinical integration, health system leaders must possess actionable data that physicians and clinicians trust. Mr. Smedley described five critical steps hospitals and health systems should take to succeed at driving progress with data. Step 1: Develop well-defined outcome metrics with targets. To achieve a culture of accountability, clinicians need to start from the same baseline. They must understand their organization's current performance and where they need to go to meet goals shared across their hospital or health system for length of stay, readmission rates and hospital-acquired infections, among other metrics. To gain physician trust and buy-in, dyad and physician committee leaders must establish standard metrics informed by robust, detailed and highly accurate data. "This is a top priority, and it is not a one-time exercise, either. Leaders must update the metrics to align with organizational goals and areas of need on a routine basis," Mr. Smedley said. Step 2: Set new performance goals and measure progress fairly. Once an organization has its outcome metrics in place, it must then work with clinicians to devise new performance goals. These goals are only important or meaningful if organizations measure physician performance in a fair and transparent manner with evidence- based quality measures, complete and accurate data sources, and standardized data collection methods. Step 3: Buy or build intelligence software to track changes. Mr. Smedley said, "The shift to value-based operating models requires organizations to synthesize data and make it actionable. Often hospitals get stuck in report development without getting to the point where meaningful analysis or action can be taken. This is where a solution, such as Premier's Physician Practice Performance Management solution, comes into play." Physician Practice Performance Management is a software- as-a-service platform designed to bolster physician practices' operational and financial performance. The solution synthesizes data to assist healthcare leaders in improving operational and financial performance by providing greater insight into the medical group. "By implementing business intelligence, and using data to inform decision-making, health systems can often identify 5 to 7 percent uptick in bottom-line improvement relative to their annual patient revenue on the medical group side," Mr. Smedley said. The financial opportunity is dependent on an organization's reimbursement model and appetite for change. Hospitals can get Physician Practice Performance Management up and running in three to four months. Mr. Smedley said it is "vital that business intelligence systems, whether purchased or built in- house, are interoperable with a health system's EHR to generate a truly coordinated operating model across the care continuum." Step 4: Share dataw and collaborate for best practice. Once trusted information has been shared, there is a natural progression toward enhanced provider engagement. Engaging with internal and external peers can accelerate learning, influence healthcare policy and inform best practices. Premier has a strong history of successfully helping hospitals and health systems outperform the market by providing a facilitated forum that brings together healthcare leaders to strategize on how to tackle common challenges. Step 5: Implement and adapt. Efforts around performance improvement are not executed in a vacuum nor are they a one- time occurrence. Using data to drive change requires continuous and effective communication, appropriate buy-in, cultural transformation, and the discipline to hardwire these changes. It is important to take inventory as to when you need a fresh set of eyes or extra hands. Sometimes it means recruiting additional personnel because there are not enough resources to do the work or a specific skill set is required. Often times, it may require reprioritizing work efforts or engaging an outside consulting firm who can help accelerate performance improvement in the areas of need. Conclusion About 45 percent of healthcare leaders predict quality-based reimbursement will increase in 2018, a recent Medical Group Management Association poll found. The time for hospitals to transition from historically inefficient, hospital-centric operating models to value-based delivery is now. The essential component of this shift is accountability. Physicians and administrators must collaborate in improving a patient's journey across the care continuum. Dyad leadership and physician committees are two ways in which hospitals can align operational goals and root employed and affiliated physicians in accountability. Physician performance data feeds insight into how new modes of accountability are functioning and is necessary to inform future operating decisions geared toward improving patient outcomes while trimming total cost. n