Volume 1 of 10:
Provider Engagement, Alignment, and Integration
There are lots of opportunities for performance improvement in healthcare today. Engaging providers in cost and quality improvements, promoting Population Health initiatives, strengthening primary care alignment, controlling avoidable utilization, telemedicine outreach, and direct-to-employer wellness programs are integral to success in today’s healthcare environment.
Engagement and Alignment are not interchangeable and it is imperative for organizations to evaluate where they are in this process. Engagement measures physician’s appraisal of their work environment, emotional experiences, and attachment to workplace. Alignment measures the extent to which a physician feels a strong partnership or connection with the organization’s leadership. By measuring both, organizations gain insight into whether physicians are likely to stay, as well as if they will support strategic initiatives.
Why is this critical to success? According to a recent American Medical Group Association (AMGA) survey, recruiting a new physician provider averages $270,000 and replacing one is an astonishing $1,200,000. This does not factor in any financial consideration for the myriad of marketplace challenges when a well-liked physician leaves a practice or organization.
The previous focus on provider satisfaction was for things like access to the OR, a supportive nursing staff, and new equipment. It has now shifted to improving patient access, customer service, and quality at a reduced cost. The driving force behind this is the shift from fee-for-service to value-based care. Readmission penalties, bundled payments, and Accountable Care Organizations (ACOs) are leading the forefront of how hospitals and providers are being reimbursed. I can’t emphasize the next point enough. You can bring on Population Health, and start other initiatives, but unless you have provider buy-in and engagement, it will go nowhere. I’ve seen organizations spend large sums of money on these programs, only to see them scale back after not engaging the medical staff first.
Trying to change years of culture is difficult at best. Hospital-Provider collaboration is operationally complex but an ever-increasing necessity. The solution is to build on mutually beneficial relationships and use existing resources wisely. On one end of the spectrum is engagement, on the other is provider burnout. There is no cure for burnout. The goal is to swing the bar more towards engagement.
Goals of any organization should be to identify physician leaders/champions and bring them to the administrative table. Creating true provider governance is key. Providers are motivated to provide the best care that they can. Having transparent, accurate, and up-to-date data will empower them to succeed in today’s environment and make them more accountable. You can engage a provider’s intellect by showing them the data and what others have achieved, they will be challenged if you as an organization are willing to look in the mirror.
Engage by creating trust and keeping patients and their care the primary focus. Implement teamwork tools and learn from mistakes. It is also important to demonstrate early success and share the results. Population Health can create provider engagement and alignment when properly integrated within an organization. It will put the focus on patient access, customer service, improved quality at a reduced cost, and quality metrics. These strategies must be physician led to succeed.
Handling barriers to change is crucial. There are always going to be the, “What’s in it for me?” attitudes. People tend to resist loss, not change. A provider’s perceived lack of time to implement any change is always a concern. Perceived loss is usually much higher than actual loss. Lack of communication with change makes the perception much higher. The sooner an organization makes the leap to this way of thinking, the better it will do. There is tremendous growth and opportunity in today’s market if willing to take a leap. Striving to maintain the status quo by doing the same thing over and over, is Einstein’s definition of insanity.
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