Medical Group Development, Operations & Planning
Physician practices, whether independent or hospital-affiliated, are experiencing financial instability driven by rising costs, shrinking reimbursement, ongoing shortages in critical specialties, and mounting regulatory and compliance requirements. In today’s climate, solo and small group practices are increasingly looking for affiliation with larger groups and/or hospitals to stabilize their compensation and provide a more secure practice environment. Existing medical groups are redesigning their structures, operations, compensation, and affiliations.
To create new physician relationships or enhance an existing physician enterprise, you need advice and guidance that combines solid technical knowledge with a cultural understanding of evolving physician practices. As experts in physician practice strategy and operations, ECG has a proven record of success in facilitating the creation, improvement, and redesign of physician organizations. Our expertise includes:
- Strategic planning.
- Governance structure development.
- Management and organizational design.
- Operations assessment/improvement.
- Compensation design and benchmarking.
- Revenue cycle management.
- Business development planning and implementation.
- Interim management.
ECG understands the unique attributes of each engagement. With on-site leadership from our most experienced consultants, we can guide you through the complexities of the critical decision-making process and the challenges of implementation.
Selected Projects
Forming a single group practice faculty structure. Expand Minimize
ECG assisted an academic medical center (AMC) in forming a single corporate physician organization from multiple clinical departments to create a clinical practice with the business, patient care, and financial authorities required for effective management while sustaining the academic medical center's commitment to its education programs. Specific activities included: analyzing the need for changing the current arrangements, formulating an organizational plan to consolidate the multiple corporate structures of the school, and developing the necessary governing documents to implement the revised arrangement. The project successfully accomplished major structural and organizational changes within a restricted time frame.
Developing an academically-centered faculty practice. Expand Minimize
ECG helped to design and develop an academically-centered faculty practice for a large urban academic medical center. The project scope included establishing a mission and a set of attainable goals for the practice, identifying the extent of group authority versus departmental authority, and developing the organizational governing documents. The outcome of this assignment was the formation of a practice structure for delivering a more integrated, comprehensive system of patient care, which offered the capability of creating joint business arrangements with other functional units of the university’s clinical enterprise.
Merging several internal medicine practices into a single medical group. Expand Minimize
ECG was engaged to assist in merging several medical groups into a single competitive entity, and subsequent to the group formation, to help them assess merger and affiliation alternatives with other local physician organizations. Specific tasks included developing a strategic plan, including a mission statement, goals, and strategic initiatives; determining ownership, membership, and governance structures; and assessing additional affiliation opportunities to address the group’s long-term strategic needs. As a result of the engagement, this group of internal medicine physicians formed a structured medical group that engages with a management services organization for administrative services and with an independent practice association for managed care contracting.
Developing a management services organization (MSO) implementation plan for an academic medical center. Expand Minimize
ECG assisted a joint venture between a university-based health system and an affiliated faculty group practice to develop a comprehensive MSO business plan and implementation plan. The plans addressed the services to be provided by the venture to physician practices; organization structure and staffing requirements; and implementation of a common billing office using IDX, including definition of central versus distributed billing functions. This engagement resulted in a detailed plan to foster the successful implementation of the MSO. ECG was subsequently engaged to provide implementation assistance.
Creating a physician-owned contracting network. Expand Minimize
ECG created and developed a contracting network which gave independent primary care physicians access to the managed care contracting resources of a large multispecialty physician group. The combined network also includes managed care support services such as contract administration, data collection and analysis, inpatient case management, and credentialing. To design the new organization, we developed and clarified the network purpose and service scope, determined the organizational governance/ownership structure, and defined the contracting approach and risk-sharing arrangements. This process resulted in the development of a successful organization that linked the 90-physician multispecialty group with independent physicians through an effective contracting arrangement.
Restructuring faculty practice governance and financial arrangements. Expand Minimize
ECG was retained by a school of medicine to restructure the governance and financial frameworks of its faculty practice. Working with a dean-designated committee of senior faculty and selected chairs, ECG helped redefine the multiple objectives of the practice, structure a streamlined governance framework capable of making timely and informed decisions, and develop an innovative funds flow model that aligns the financial objectives of the departments and faculty and creates a set of common financial objectives. The department chairs unanimously endorsed the task force recommendations, and the streamlined governance structure and revised funds flow model were successfully implemented.
