ECG Management Consultants

The relationship between a hospital/health system and its medical school/university partner is typically codified in an affiliation agreement. These documents define the business terms that guide participants’ collaborative involvement in educational, research, and clinical activities. While managerial authorities, participant responsibilities, and transactional clarity are fundamental to any affiliation agreement, it is the structure and design of the affiliation governance model that is most predictive of the participants’ ability to successfully advance the partnership in the future. This Executive Briefing provides an overview of a productive strategic affiliation agreement and how an effective affiliation governance model can elevate the status and success of each affiliate partner.

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With the passage of the Patient Protection and Affordable Care Act (ACA), all not-for-profit, nongovernmental hospitals must complete a 3 year community health needs assessment (CHNA) by the end of FY 2013. The stakes are high – hospitals face a $50,000 excise tax for each year their CHNA remains outstanding and risk losing their not-for-profit status. While the CHNA is a regulatory mandate, it can be more than just a box-checking activity. This Executive Briefing discusses how the CHNA can provide a new opportunity for hospitals to pursue their mission and expand their presence in the regions served, identifying the needs of the community and how they intersect with the organization’s strategic plan.

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Beginning in 2014, Affordable Care Act (ACA) reforms will result in an influx of patients with new insurance benefits via health exchanges and potential Medicaid expansion. Concurrently, Medicaid rolls will continue to burgeon due to the economic downturn, driving states to explore more cost-effective managed Medicaid solutions. Organizations will need to leverage external care resources to optimize care for beneficiaries newly insured through exchanges and prepare for expanded risk-based reimbursement for all populations. This Executive Briefing explores how building strategic partnerships between hospitals, health systems, and Federally Qualified Health Centers (FQHCs) is a key pathway to successfully prepare for the future and maximize the community benefit of investments.

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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.

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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.

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The financial, strategic, and clinical importance of developing a comprehensive cancer program is undisputed. And yet the capital commitment to bring all the pieces of the care continuum together in a single location can be cost-prohibitive. Are virtual cancer centers a solution? This presentation explores a variety of strategies, including tumor conferences, focal sites of expertise, and EMRs, that have been used to successfully integrate clinical services across a regional network.

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In an environment where value is rewarded, high-functioning multispecialty practices are positioned to have a strategic advantage. This presentation provides detailed case studies of how two organizations with differing organizational characteristics, capabilities, and market conditions are utilizing their respective employed physician organizations to lead organizational transformation efforts toward integrated care delivery.

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By developing a service line, hospitals hope to improve performance, encourage physician involvement, and gain a competitive advantage in the market. This session discusses the management and governance structures that differentiate top-performing service lines and outlines reasons for seeking specific designations and accreditations. Additionally, this presentation focuses on examples from cardiovascular service lines and explores the benefits of service line organizations.
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In order to take an analytical approach to financial performance improvement, an organization must define an area of focus, perform a situational assessment, establish dashboards to benchmark and monitor improvement efforts, and align individual incentives to stated objectives. In many cases, the situational assessment and ongoing performance monitoring can be more effectively carried out with the use of robust business intelligence tools. This presentation discusses both the methods and tools that can be employed when analytics are used for strategic and operational benefit.

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With medical groups facing reimbursement pressures and declining volumes, organizations are reviewing every aspect of their operations to make fundamental changes to the ways they function. In an environment where savings are rewarded, it may be more difficult for efficient organizations, such as those in the Northwest, to reap ongoing benefits. This presentation explores the keys to success in this new environment, including developing a Medicare strategy, collaborating with payors, aligning physician incentives, building operational effectiveness and stability, and exploring new partnerships.

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