Strong and productive physician-hospital relationships are essential to improving outcomes at acceptable costs. Aligning key stakeholders with your financial imperatives and clinical operating processes are the central keys to navigating the transition to value-based payments that can add up to 5% in incremental margin.
Progressive recently helped a community health system client capitalize on the transition of the State’s Medicaid program to managed care. The core strategy focused on a “shared savings” bonus program with guaranteed case management fees paid on a PMPM basis for 13,000 lives. We also developed a PHO that allowed the client to include independent physicians (nearly 50% of all physicians in their service area). The client has realized over $1 million in margin from PMPM and bonus payments, which was then applied to enhanced physician compensation and care management infrastructure.
Progressive Healthcare’s Physician & Hospital Alignment focuses on:
Partnering with non-employed physicians
Refining physician employment contracts to improve both incomes and outcomes
Implementing Care Management initiatives to drive ROI for both physicians and hospitals; without massive IT investments (e.g. via Chronic Care Management)
Cultivating physician leadership that will initiate and manage change
Understanding and assimilating payors into the outcomes strategy