copyright 2014, the greeley company, inc. all rights reserved. these materials may not be duplicated...

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Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley Company, Inc. The Changing Medical Staff What Physician Employment, Service Lines, and Clinical Integration Mean for your Medical Staff Rick Sheff, MD The Greeley Company

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Page 1: Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley

Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley Company, Inc.

The Changing Medical StaffWhat Physician Employment, Service Lines, and Clinical Integration Mean for your Medical Staff

Rick Sheff, MD

The Greeley Company

Page 2: Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley

©2012, The Greeley Company, a division of HCPro, Inc. Confidential. All rights reserved. Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley Company, Inc.

Institute for Healthcare Improvement (IHI) Triple Aim

• Improve the health of the population

• Enhance the patient experience of care (including quality, access, and reliability)

• Reduce, or at least control, the per capita cost of care

Page 3: Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley

©2012, The Greeley Company, a division of HCPro, Inc. Confidential. All rights reserved. Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley Company, Inc.

Clinical integration models

• Physician Employment?

• Service Line Management

• Accountable Care Organization (ACO)/Clinically Integrated Network (CIN)

Page 4: Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley

©2012, The Greeley Company, a division of HCPro, Inc. Confidential. All rights reserved. Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley Company, Inc.

To whom are physicians accountable and for what?

Page 5: Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley

©2012, The Greeley Company, a division of HCPro, Inc. Confidential. All rights reserved. Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley Company, Inc.

Governing Board

CEO MEC

Single hospital traditional self-governed organized medical staff org chart

Department Chair

Individual Practitioners

Page 6: Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley

©2012, The Greeley Company, a division of HCPro, Inc. Confidential. All rights reserved. Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley Company, Inc.

System board, medical staff and management relationships

System Governing Board

Local Board

MECHospital CEO

System CEO

Regional VP

Page 7: Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley

©2012, The Greeley Company, a division of HCPro, Inc. Confidential. All rights reserved. Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley Company, Inc.

Board of directors

CEO MEC

VPMA/CMO

It’s getting complicated…

Medical Director

Department Chair

Individual Practitioners

Other Entities (Employed Phys, ACO/CIN, SL Co-Mgmnt, etc.)

Page 8: Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley

©2012, The Greeley Company, a division of HCPro, Inc. Confidential. All rights reserved. Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley Company, Inc.

Appoint excellent physicians

Set, communicate, and achieve buy-in to expectations

Measure performanceagainst expectations

Provideperiodicfeedback

Manage poor performanceTake corrective action

The Physician Performance PyramidKeys to achieving great physician performance

© 2014 The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley Company, Inc.

Page 9: Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley

©2012, The Greeley Company, a division of HCPro, Inc. Confidential. All rights reserved. Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley Company, Inc.

Manage poor performance

Take corrective action

Provide periodic feedback

Set, communicate, and achieve buy-in to expectations

Appoint excellent physicians

Measure performance against expectations

The Physician Performance Pyramid

© 2014 The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley Company, Inc.

Page 10: Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley

©2012, The Greeley Company, a division of HCPro, Inc. Confidential. All rights reserved. Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley Company, Inc.

Manage poor performance

Take corrective action

Provide periodic feedback

Set, communicate, and achieve buy in to expectations

Appoint excellent physicians

Contract to reinforce expectations

The Physician Performance Pyramid

Measure performance against expectations

© 2014 The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley Company, Inc.

Page 11: Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley

©2012, The Greeley Company, a division of HCPro, Inc. Confidential. All rights reserved. Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley Company, Inc.

How does physician employment by hospitals impact the medical staff?

Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley Company, Inc.

Page 12: Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley

©2012, The Greeley Company, a division of HCPro, Inc. Confidential. All rights reserved. Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley Company, Inc.

Key medical staff issues for practitioner employment• To whom is the practitioner accountable for their

performance?

• Who manages practitioner performance (implements the layers of the Pyramid)?

• Will peer review information be shared with HR and HR information be shared with peer review?

• Will there be a relationship between membership/privileges and employment or not?

• Will employed physicians be eligible for medical staff leadership positions?

Page 13: Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley

©2012, The Greeley Company, a division of HCPro, Inc. Confidential. All rights reserved. Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley Company, Inc.

How do service lines impact the medical staff?

Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley Company, Inc.

Page 14: Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley

©2012, The Greeley Company, a division of HCPro, Inc. Confidential. All rights reserved. Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley Company, Inc.

What do we mean by a service line?

• Coordinating and optimizing care across the cointinuum for a defined group of patients

• Typical service lines– Cardiovascular– Ortho– Neuro– Oncology– Women and Children

• May or may not involve service line co-management

Page 15: Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley

©2012, The Greeley Company, a division of HCPro, Inc. Confidential. All rights reserved. Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley Company, Inc.

Key medical staff issues for service lines

• To whom is the practitioner accountable for their performance?

• Who manages practitioner performance (implements the layers of the Pyramid)?

• Who conducts peer review?

• Will peer review information be shared between the service line and the organized medical staff?

• Will peer review in the service line be protected from discoverability?

• Will service line leaders have a role in medical staff leadership?

Page 16: Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley

©2012, The Greeley Company, a division of HCPro, Inc. Confidential. All rights reserved. Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley Company, Inc.

How does an ACO/CIN impact the medical staff?

Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley Company, Inc.

Page 17: Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley

©2012, The Greeley Company, a division of HCPro, Inc. Confidential. All rights reserved. Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley Company, Inc.

Key medical staff issues for ACO/CINs• Who’s in and who’s out?

• Will the medical staff services department play a role in credentialing for the ACO/CIN?

• To whom is the practitioner accountable for their performance?

• Who manages practitioner performance (implements the layers of the Pyramid)?

• Who conducts peer review?

• Will peer review information be shared between the ACO/CIN and the organized medical staff?

• Will peer review in the ACO/CIN be protected from discoverability?

• Will ACO/CIN leaders have a role in medical staff leadership?

Page 18: Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley

©2012, The Greeley Company, a division of HCPro, Inc. Confidential. All rights reserved. Copyright 2014, The Greeley Company, Inc. All rights reserved. These materials may not be duplicated without the express written permission of The Greeley Company, Inc.

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