ECG Management Consultants

Hospitals across the nation are increasingly turning to call coverage compensation arrangements as a means of providing vital medical services and remaining in compliance with federal law. While the number and complexity of these agreements have grown, many healthcare organizations are entering into such contracts despite uncertainty that the terms are both legally defensible and financially prudent. This Diagnostic addresses some of the most pressing and frequently asked questions about call coverage arrangements and suggests a robust, thoroughly vetted methodology for arriving at payments that are individually tailored to a given arrangement and remain within the appropriate market range.

In the next few years, we expect compensation and production trends to be most impacted by the continued shortage of primary care physicians, increased demand for specialty care, and implementation of key provisions of healthcare reform. This presentation discusses physician market trends, nonproductivity compensation frameworks, benchmark data, compensation plan examples, and how to align compensation with performance.

Physician compensation and performance incentives are undergoing a fundamental shift as healthcare providers embrace value-based delivery models. Physician organizations generally recognize that production-driven plans will need to evolve to reflect changing economics, but there is a reluctance to move too far ahead of reimbursement changes. In this presentation, we review the impact of healthcare reform on provider compensation and plan methodologies, including emerging physician compensation plan trends; compensation trends relative to production for primary care, surgical, medical, and hospital-based specialties; market trends in APC compensation; and value-based compensation considerations.

Physician practices, whether independent or hospital-affiliated, are experiencing financial instability driven by rising costs, shrinking reimbursement, ongoing shortages, and mounting regulatory compliance requirements. This presentation discusses key steps that can be taken to attain financial, operational, and organizational success in your physician practice and specifically identifies and provides examples of trends that are driving a greater need for practice improvement and benchmarking.

Healthcare organizations are mobilizing their physician and administrative leaders to expand their focus beyond volume to include service experience, cost, quality, and outcomes. If these organizations are to succeed, substantial work is required to create the care delivery model of tomorrow while they continue to provide care today. Probably the most critical elements in this transition are physicians who have the most direct line of sight on both cost and quality. Not surprisingly, there has been a surge in interest in transitioning to physician compensation systems that are more closely aligned with the value-based future. However, in the flurry of activity surrounding paying doctors based on “value,” we repeatedly see healthcare organizations with a strong sense of urgency despite a poorly defined direction. This Insight provides the information necessary to help you decide how to best manage the pace and implications of payment reform on physician compensation within your organization.

As hospitals, health systems, and academic medical centers (AMCs) begin to evaluate their first series of physician transactions (e.g., employment, Professional Services Agreement [PSA]) that occurred during the past 3 to 5 years, many are now revisiting the fundamentals of physician compensation. The central challenge for most organizations is to develop physician incentives that drive productivity and quality while ensuring that compensation remains grounded in the fiscal reality of the organization – an aspect of plan design that is often overlooked (e.g., during the 1990s). As such, the long-term financial feasibility of past approaches that merely index compensation to benchmarks (e.g., median compensation per WRVU) and assume health systems take on full financial risk are beginning to be questioned. This Executive Briefing highlights five trends that are emerging nationally and includes recommendations for organizations seeking to take a proactive approach to physician compensation plan design in this rapidly evolving market.

While healthcare organizations nationwide are striving to avoid losses from practice acquisitions, many are still taking a hit. This presentation examines the financial life cycle of an employed practice and how long it takes to achieve profitability. It also provides guidelines and principles for maximizing performance, including how to measure financial and operating performance; determine an ideal network size; develop models for leadership, compensation, productivity, and EMR implementation; and address performance and quality issues.

Faced with impending physician shortages, how can healthcare organizations improve access and patient throughput? This presentation examines how The Carle Foundation redesigned the scheduling process, physician work standards, and delivery model to center around the patient and grow market share. In addition, it describes how executives worked with physician leaders to set expectations and performance standards.

Accountable care organizations are under way, and healthcare organizations are weighing their options. This panel discussion offers a discussion among health system executives about their accountable care strategies.

Is your organization struggling with integrating your service and physician group structures? How are the roles of your leadership and management team evolving in this changing environment? Right or wrong, the idea of private practice is fading, as the majority of physician practices are now owned by hospitals. This presentation explores how organizations are structurally evolving and creating new management positions in response to this transition.