Physician and Provider Engagement and Alignment
Hospital Best Practices and Recommended Strategies
Physician Engagement
- Use the Rural Provider Leadership Summit Report to identify strategies for engaging physicians and other rural providers in discussions on transitioning to value-based systems
- Utilize Rural Health Value tools and resources to build relations with providers and engage physicians
- Build awareness with medical staff and board members that Centers for Medicare & Medicaid Services (CMS) is transforming:
- Explain to medical staff and board members that under the MACRA Quality Payment Program, physicians must select one of two paths to value
- Merit-Based Incentive Payment System (MIPS), which determines payment based on quality, resource use, clinical practice improvement, and meaningful use of certified EHR technology
- Alternative Payment Models (APMs) such as Accountable Care Organizations (ACOs), Patient Centered Medical Homes, and bundled payment models (refer to CMMI for Innovation Models)
- Build awareness with medical staff and board members that Physician Compare is an online resource that allows patients and their families to find physicians and other health care professionals, provides information to assist patients with decision-making about their health care, as well as tie incentives to performance.
- Educate medical staff and board members by encouraging them to watch the following short CMS videos about MACRA, MIPS, APMs, and Physician Compare
Physician Alignment
- Align and partner with physicians and other providers to successfully transition to a value-based system and prepare for population health
- Partner with physicians to develop a common vision, goals and initiatives focused on increasing quality of care and creating value to position the hospital for participating in shared savings programs, Accountable Care Organizations (ACO) and patient centered medical homes
- Develop an integrated clinical physician and hospital leadership team
- Coordinate a local provider network to generate referrals for specialty services and other inpatient services to maximize revenue in a fee-for-service payment environment, at least during the transition period
- Build relationships with other regional hospitals and physicians to position the hospital for developing and implementing affiliation strategies
- Align with physicians through:
- Functional alignment, such as shared medical records and billing
- Governance alignment, such as a shared management team
- Contractual alignment, to include both employed and non-employed physicians
Physician Incentives
- Develop physician contracts based on Relative Value Units (RVU) and include productivity bonuses and incentives for, quality, patient outcomes and experience, reduced cost, growth, panel size and timely chart completion. Refer to the sample physician agreement.
- Consider the following recommendations for developing and managing physicians contract based on RVU:
- Set the base compensation at an attainable level such as 50th percentile of Medical Group Management Association (MGMA) benchmarks. However, consider 25th to 35th percentile for new providers
- Establish a minimum threshold for pre-determined dollar amount per RVU (or Work RVU) once the threshold has been met
- Develop the RVU based incentives to directly correlate between provider effort and incentive dollars
- Provide physicians monthly updates on performance measures relative to goals
- Establish a practice manager role to provide oversight of operations and ensure proper goal alignment between physician practice and hospital
- Establish policies related to chart completion incorporated into the providers’ employment contract and disciplinary action is taken if providers do not adhere to the policy.
Related Content
Learn evidence-based approaches to implementing a successful Community Health Improvement Plan by partnering with the community to address leading causes of disease while accounting for SDOH.
The webinar covers the various components of value-based care and explains how the new alternative payments models will make a positive difference for rural hospitals.
Dr. Davis explores the impact value-based reimbursement, MIPS and APMs have on physicians. The participation choices and the effect of employment in a FFS environment, RHCs and FQHCs are discussed.
As CAHs and small rural hospitals evaluate whether to participate in an APM, it is important for leadership to evaluate the APM model from a business plan perspective. Learn about the financial strategies IRCCO has undertaken to prepare clinical integration.
Learn details of APMs and how Medical Home models can improve care coordination, quality and decrease costs, how rural hospitals can engage and educate clinicians, health care organizations and the community in order to achieve common cost and quality goals. Discover ways to return joy to providers.
Learn why small and rural hospitals should consider voluntarily participating in MIPS and how your hospital/clinic can deliver and engage patients and other health care providers to deliver population-based health care that focuses on patients across the spectrum of care in your community.
Get an overview of MACRA’s QPP, eligibility requirements, and impacts on payment, quality and cost. Learn how a Value Based Care system can leverage patient and provider engagement.
Findings of the 2016 Rural Provider Leadership Summit are presented. You will learn the drivers and challenges related to engaging rural providers in value-based models as the speakers share the strategies and success stories identified.
Hospital leadership of Jefferson Healthcare in Port Townsend, Washington discuss ways to engage physicians in care coordination and PCMH teams.
Learn how an understanding of physician and leadership differences can increase the likelihood of trusting relationships and shared visions with specific administrative strategies for meaningful physician engagement.
Learn how to forge new relationships with physicians, including pay-for-performance contracts, gainsharing arrangements and new medical staff models.
This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UB1RH24206, Information Services to Rural Hospital Flexibility Program Grantees, $1,009,121 (0% financed with nongovernmental sources). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.