Physician-hospital partnerships: incentive alignment through shared governance within a performance improvement structure.

Background: Producing accessible, appropriate, and accountable medical care that improves the health of the populations served requires collaborative physician-organization relationships within which performance measurement across the continuum of care occurs. Governance and shared responsibility for performance improvement (PI) through organizational structure and process have proven to be particularly complex challenges.

Redesign Of The Pi System: The Health Alliance of Central New York, based in Syracuse, New York, which consists in part of Crouse Hospital; ambulatory medical care sites and physicians; a physician organization, a physician-hospital organization, and an independent practice association; in February 1997 established a plan for a redesign of the PI system.