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Physician Strategy News^®

Healthcare Strategy Group's Physician Strategy News^® is published eight times a year, highlighting trends in hospital/physician relationships and effective strategies for growing and managing those relationships.

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2010

May 2010
- Economic Integration: Success or Failure - Weigh Options
  Over the last four issues, we have introduced and discussed our model for Building Successful Physician Alignment Strategies. That model, included in our pyramid on page 2, outlines the various elements of alignment and places them in a hierarchy. In this
- Addressing Primary Care Need in the Face of Healthcare Reform
  Shortages of primary care physicians are becoming more and more commonplace and medical schools produce fewer and fewer residents with a primary care specialty. Driven by a lack of compensation for their services, primary care physicians compose only 31%
- Shifting Requirements for Physician Needs Analyses
  The Patient Protection and Affordable Care Act imposes new requirements for nonprofit hospitals related to community needs assessments.
- Recruiting: Aggressive Enough?
  With the national physician shortage, recruiting has never been more important. And healthcare reform will likely increase demand as more people are insured, exacerbating the problem.

March 2010
- Developing A REAL Marketing Strategy
  • Building a Successful Physician Alignment Strategy_Pyramid
- Producing Value From Your Employed Physicians
  Major investments and significant losses are too often the outcome when hospitals employ physicians.
- Physician Leaders and ACOs
  The success of Accountable Care Organizations (ACOs) is dependent on its ability to change clinical practice. To sustain such change, physicians must be actively engaged in leadership of the change process.
- Physician Shortages Threaten Service Line Development
  Physician shortages are driving up the recruitment costs and salaries of some specialists. And those market challenges are not distributed evenly among hospital service lines.

February 2010
- Accountable Care Organization Readiness
  Accountable Care Organizations (ACOs) are receiving increased interest, as evidenced from the Brooking-Dartmouth demonstration sites to the interest in Washington, that relates to the floundering reform efforts.
- Five NEW Questions About Physician Manpower Planning
  Physician manpower is at a premium, that is not breaking news. Hospitals are scrambling to recruit the physicians they need, and interest in retention has never been higher.
- Being HITECH: Risks and Rewards
  The Health Information Technology for Economic and Clinical Health (HITECH) Act is part of Obama's stimulus package. HITECH's main goal is to give physicians incentives to adopt electronic health records (EHRs).

2009

December 2009
- Five Strategic Questions You MUST Answer
  • Building a Successful Physician Alignment Strategy_Pyramid
- Manage Physician Satisfaction, or Else
  Market forces are driving hospitals and physicians to partner for survival, and like all partnerships, these relationships require attention.
- Psychiatric Coverage Solutions
  Skip this article if your hospital has no challenges in addressing the psychiatric service needs of your patients. Based on our experience, most of you are still reading.
- Recruit to Private Practice or Employment?
  Many hospitals struggle with the political and strategic implications of the decision to recruit to private practice or employment.

November 2009
- Building Mutual Success Through Physician Alignment
  Hospitals are focusing intensely on their physician alignment efforts, and our firm is helping many of them with that focus.
- Eight Questions to Maximize the Value of Medical Staff and Service Line Development
  • Building a Successful Physician Alignment Strategy_Pyramid

September 2009
- Aggregation of Practices and Ancillaries
  Hospitals are purchasing many small physician practices, then facing the reality that the status quo does not maximize value. Our experience is that groups of 6-10 physicians yield the most productive situation.
- Maximizing Service Line Growth
  Building and maintaining strong service lines is central to growth and can require significant investment. And, with today’s economic climate magnifying risk, strategically defining your investments within a service line could not be more important.
- Physicians on the Move
  Is your facility struggling to retain physicians from key specialties? If so, you’re not alone. In May 2009, SK&A released data regarding the six month move rate of 87 specialties. We examined the data and found some interesting trends.
- The Stimulus and Employed Practices
  The Obama administration’s stimulus package has six core elements that potentially could have a major affect on physician practices. Some of these elements are positive, while others create potential challenges.

June 2009
- Employer Health Clinics - Threat and Opportunity
  There was a time when the jobsite clinic was a band-aid station, a place to assess work-related injuries and get people back to work. These clinics were just marginal players in the health care system, but that’s changing.
- OIG and Call Compensation
  In a May 21 Advisory Opinion (09-05), the OIG issued an opinion that should make hospitals feel good about some compensation to physicians who are on call, while at the same time causing concern about another element of such pay.
- Stark and Real-Time Community Need_2
  In a July 31, 2008 article in Hospitals & Health Networks, principals of the Noblis Center for Health Innovation reviewed the implications of Stark 3 on physician recruitment.
- Strategic Considerations in Physician Acquisition
  Today's economy is creating challenges for practices unseen in previous years.
- Trends in Physician Alignment Strategies
  Over the past couple of years, our firm has completed fifteen client engagements that focused on physician alignment strategy. These projects were each tailored to the unique needs of the individual organizations and their diverse markets.

May 2009
- Governance Models That Work
  Governance is a key factor in the success of employed physician groups.
- How Will Reform Affect Your Alignment Strategies?
  Reform is coming. The only question is whether it will be systemic or incremental. Many of the current proposed reforms carry implications for physician alignment strategies.
- Important Design Considerations for Your New Physician Practice Space
  When planning a new physician practice suite or building, the goal is to create a layout that both facilitates patient care and staff productivity.
- Keys to Effective Physician Compensation 2009
  Developing and implementing an effective physician compensation plan for a group of employed physicians is a difficult and complex task.
- Specialties in Short Supply
  Your facility will likely struggle to recruit some needed doctors, no matter how hard you try. This reality is due to the supply of physicians in residency training.

March 2009
- Case Study: Capturing New Geographic Markets
  HSG was engaged to complete a strategic plan for a hospital system in a growing market. Attractive new markets that represented growth opportunities were defined in the market evaluation.
- Could Co-Management Be Your Alternative To Employment?
  As economic conditions worsen, increased competition and pressure for improved patient care press on hospitals and physicians, there is a growing trend to utilize the physician employment model as a solution.
- Developing Successful Physician-Health System Joint Ventures
  One of the biggest challenges facing physicians and health systems today is finding ways to work together to protect market share and profitability.
- Does Your Hospital Culture Support Physician Alignment?
  Do members of your management team even like physicians? Does the team value the physicians’ knowledge and view capturing and leveraging that knowledge as vital to the organization’s success?
- Getting Your Network Strategically Focused
  Around the country, hospitals are assembling networks of physicians. Driven by the economics of medical practice, many physicians are seeking partnerships with hospitals because they are perceived to be relatively stable and have greater market power.

January 2009
- Are Physicians Working Harder?
  When working with clients to develop physician compensation plans, two concerns are repeatedly expressed...
- Cost-Effective Physician Manpower Planning
  Our Physician Needs Analysis (PNA) will reduce your consulting costs for manpower planning.
- DRG Changes Affect Specialty Profitability
  The new MS-DRG system created by CMS has increased hospital reimbursement by about 3%, based on an analysis by the American Hospital Directory.
- Economic Challenges Driving Alignment
  In this economic environment, the substantial challenges to hospitals will only grow.
- Five Approaches to Leveraging Your Investment in Alignment
  Hospitals have invested in alignment through employment, co-management relationships, joint ventures and other approaches.
- Health Reform and Physician Alignment
  If Barack Obama gets his wish for reform, how will it affect you and your physicians?

2008

October 2008
- Basics of Time Block Leasing
  The regulatory environment is quickly changing and those changes are affecting how certain physician deals must be structured.
- Co-Management: A Flexible Approach to Physician Engagement
  Much has been said and written about how pay-for-performance structures.
- Producing Value from Employed Practices
  With the trend toward physician employment growing, hospitals are working to achieve value from these relationships.
- Stark and Real-Time Community Need
  In a July 31 article in Hospitals & Health Networks, principals of the Noblis Center for Health Innovation reviewed the implications of Stark 3 on physician recruitment.

August 2008
- Improving Practice Collections
  As reimbursement continues to decline and expenses rise, it is important that medical offices scrutinize their collection practices.
- Practice Start Ups
  When starting a new physician practice there are several steps that must be taken to ensure proper and timely set up.
- Strategic Responses to Physician Competition
  Competition from physicians is nothing new.

June 2008
- Advanced Manpower Planning
  Most hospital executives are familiar with the basics of physician manpower planning.
- Building a Physician Employment Strategy
  Hospitals are increasingly confronted by the challenge of employing physicians.
- Three Strategic Planning Missteps
  The approach hospitals take to strategic planning is often fraught with problems.

May 2008
- Growing Threat of Retail Medicine
  Retail medicine outlets are exploding across the United States.
- Performance Measures for Physician Practices
  Whether hospital employed or private practice, it is imperative that a practice's performance be measured and monitored on a monthly basis.
- Practice Acquisition - Part 3 The Acquisition is Complete: Now What?
  After months of careful due diligence and challenging negotiations the contract is signed and the hospital finds itself with a new employed physician, financial obligations, employees, management responsibilities, exposure, and opportunity.
- Ten Questions for Building a Physician Strategy
  Few relationships are more central to the success of the hospital than the one between the organization and physicians.

March 2008
- Call Pay Solutions
  Call pay is a growing challenge for hospitals.
- Physician Needs Analysis Case Study
  Community Hospital was acquired by a regional health system, with the objective of stabilizing operations and improving access to capital.
- Physician Practice Consolidation Checklist
  In today's healthcare environment there are a myriad of reasons for physician practices to consider consolidation.
- Physicians & Service Line Development
  When hospital executives read these words, they have a variety of reactions.
- Practice Acquisition Basics - Part 2
  This article addresses the next steps in the practice acquisition process - development of the term sheet and contract.

February 2008
- Growth Through Physicians
  Hospitals around the country are focused on growth, for obvious reasons.
- Maximizing Your Physician Liaison Program
  The New Year presents new opportunities, and now might be a perfect time to re-evaluate your physician liaison program.
- Physician Practice "Check-ups"
  As an executive with a hospital that employs physicians, you want to know about the overall health of those practices.
- Practice Acquisition Basics - Part 1
  Many hospitals are faced with the new and unfamiliar challenge of acquiring physician practices.

January 2008
- Keys to Effective Physician Compensation
  Developing and implementing an effective physician compensation plan for a group of employed physicians is a difficult and complex task.
- Strategic Planning for Practices
  Despite being large, complex businesses, many physician practices never develop a strategic plan.
- The Evolving Landscape of Hospital/Physicians
  The relationships between physicians and hospitals are changing.

2007

October 2007
- Developing Physician Leaders
  Strong physician leadership has rarely been more important.
- Interim Practice Management
  As hospitals employ physicians or acquire practices, management of the new entity is frequently a challenge.
- Is Gainsharing in Your Hospital's Future?
  As the landscape of healthcare continues to evolve, hospitals and physicians are looking to better align incentives.
- Quantifying Anesthesia Subsidies
  Anesthesia groups are increasingly asking for subsidies as a result of a number of factors, including poor Medicare reimbursement and a tight supply of practitioners.

August 2007
- Physician Employment Readiness Assessment
  Has the board received education on trends in physician employment?
- The Cons and the Pros of Physician Employment
  Boards and executives in many hospitals are struggling with the concept of physician employment.
- Three Dimensions of Physician Alignment
  Alignment with physicians is the holy grail of hospital operations.

May 2007
- Creating Synergy Among Your Strategies
  Historically, hospitals have separated strategic planning, physician manpower planning, and physician strategy.

March 2007
- Developing a Practice Management Infrastructure
  While hospital executives are very skilled at running hospitals, they often fall short when trying to manage their employed physician groups.

January 2007
- Building Medical Staff Support for Your Recruitment Plan
  When hospitals plan the recruitment of new physicians into their community, whether into private practice or employment, resistance from the established physicians is not uncommon.

2006

November 2006
- Case Study: $10 Million Employed Physician Practice Turnaround
  A client healthcare system employed about 90 physicians in 15 practice sites and was losing $12 million a year on those practices.

July 2006
- Deciding to Employ Physicians?
  Fueled by physician shortages, distribution issues, competition, and the growing financial challenges of private practice, hospitals and health systems are increasingly looking to physician employment to guarantee supply and meet their strategic goals.

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