RFS news highlights resources, issues, and news relevant to in-training members of the ACR. If you have a topic idea or would like to contribute to the blog, please email RFS Secretary Nathan Coleman, MD.
Is Co-Management the Future of Health Care?
A recent Imaging 3.0 case study charts one practice’s strategy for adapting to the future of health care.
As we all know, the current health care system is continually changing. We’re seeing more direct employment of physicians by hospitals, new payment models, and increasing demands for more efficient and cost-effective health care. In this dynamic health care climate, the ultimate focus for an organization revolves around the patient’s experience, quality of care delivered, and cost.
The marketplace grows more competitive every day, and organizations must evolve and adapt to the current changes in order to survive.
One community-based practice charting a course in this new world is Radiology Associates of Canton (RAC), the subject of a recent Imaging 3.0 case study. In 2011, president and CEO Syed F. Zaidi, MD, felt the strain of the changing health system. The demands of increasing volume and reimbursement cuts impeded the practice’s ability to provide consulting services to clinicians. This threatened hospital relations. The answer to the problem was a co-management relationship with the hospital. The goal was to align the goals of the practice and the hospital while taking joint responsibility for providing better patient care.
In order to implement this method of management leadership, RAC worked closely with hospital administration to create a common aim. A shared governance model forged a relationship that focused on improving the quality of patient care but as a unified team with shared accountability. A pay-for-performance program included metrics agreed upon by the practice and hospital for items like turnaround times and clinical outcomes. These metrics allowed for measurable improvements, helped hospital compliance with joint commission standards, and encouraged engagement with referring physicians.
In addition to upgraded metrics, clinical coordinators were hired to expedite patient care. This and other patient-centered changes led to a measurable reduction in time between imaging and biopsy, fewer repeat biopsies, decreased length of stay for patients, and overall reductions in spending costs while also improving patient satisfaction.
In addition to RAC’s arrangement with its hospital, other institutions are seeing the benefits of integrating physician-hospital leadership, including major institutions like the Mayo Clinic and Kaiser-Permanente. You might be wondering why this model is not implemented everywhere. The answer is that, unfortunately, not all health care organizations have laid the groundwork to adopt this model.
Structured collaboration between physician leaders and hospital administration is not a simple endeavor. Transparency and shared goals need to be openly supported while, at the same time, clinical autonomy needs to preserved. Not all institutions share these values and many are committed to old models. Physicians and hospital executives alike will need to possess the necessary leadership skills for integration. If we want to be successful in the future of health care, we’ll need to work with all of health care’s participants to create a new culture.
By Travis Fuchs, MD, PGY2 resident at SUNY Downstate Medical Center