Developing a neighborhood primary care strategy.

For building and maintaining a primary care workforce to staff an integrated care delivery strategy, considerations include: > Geographic presence > Patient care modeling > Professional staffing.

Breaking even with hospital-owned practices.

Performance improvement in hospital-owned practices requires: The organizational will to sponsor change. Decision-making partnerships between physicians and executives. Effective implementers to drive change at the practice level.

Hospital-owned medical practices gaining the benefits without the losses.

Hospitals can correct most of the causes of reduced performance in hospital-owned medical practices by setting appropriate performance expectations and implementing correct operating principles. Engaging employed physicians and executives as partners who provide principle-based direction and support to practice managers encourages performance improvement. A critical determinant of a hospital's ability to successfully own medical practices is understanding and implementing the principles for success in this unique ambulatory business.

Accountable primary care a critical investment.

Primary care physicians today can be expected to capture between 2,000 and 5,000 active patients who consider that physician to be "my physician." The geographic location of primary care physicians affects the payer mix of the hospital and its affiliated subspecialists. Hospital and health system CFOs would be wise to advocate investment in primary care physicians to secure market share.

Avoid costly mistakes of the past.

Physician employment is here to stay. The challenge for healthcare finance professionals is to make physician relationships work without the financial losses experienced by hospitals that tried physician employment in the past. Capturing market share should be a key strategy in any physician employment effort.

Working together toward a shared vision for care.

To work together, physicians, finance leaders, and other executives need: A shared vision that is compelling enough to promote cooperation, A culture of accountability, which helps weed out the disrupters who can stall change, Forums to identify implementation tactics, Leadership skills, which help them come together to solve problems.

Think big, act small.

As hospitals and health systems grow, they need to focus on the smallest unit of service-the patient visit. Physicians and managers should have the authority and accountability that allows them to work together at the local level to serve patients and solve operational issues. As long as patients and physicians have a choice, the delivery of medical services will be an individual relationship business.

Integration: from structural to functional.

Because of trends that are driving increased consolidation in the healthcare industry, community healthcare systems in the future will have fewer independent medical practices. Hospitals and physician practices can be structurally or functionally integrated, but those that are structurally integrated only, do not function as integrated health systems. For successful integration, leaders from many disciplines need to engage in a partnership and be willing to create conditions for a functional integration.

The drive to survive: independent medical practice.

The "hospital of choice" for independent physicians will have the following characteristics: Adequate capital for investment in human resources, technology, and facilities. A strong and sustainable market position based on affiliated primary care practices. The ability to engage physicians as business partners.

Physician compensation 5 mistakes, 1 solution.

Compensation models for employed physicians should be based on productivity and adhere to four key principles: Focus on factors physicians can control. Include productivity-based risk and reward. Allow physicians to control personal income.

4 business imperatives to manage dynamic change in healthcare.

The rapidly shifting healthcare landscape requires all-wheel-drive management. Organizations must expect and be prepared for constant change.

Here we go again. A primer on helping hospital-owned physician practices succeed.

Hospitals are getting back into the physician practice business. What do trustees need to know to ensure success?

Does your organization have a central business processing office?

A central processing office (CPO) is an alternative to the traditional central billing office that can substantially improve the revenue cycle performance of a hospital's owned physician practices. A CPO's primary advantage is that it assigns accountability for results at each revenue cycle step, particularly to those individuals in the practices who have the best access to patients and their information. Empowering the practices to solve their own errors gives the CPO team more time to devote to managing claims and payers.

The case for a medical practice retail strategy.

The provision of medical care is assuming some of the characteristics of retail services delivery. This article outlines some of the factors that impact consumer (patient) decision-making in selecting providers. It focuses on measures that practices and institutions may adopt to improve patient satisfaction and to establish and maintain the referral chain.