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Construct Clarity in Physician-Hospital Alignment: The Need for Precision in Definition, Measurement, and Management Comment on "Alignment in the Hospital-Physician Relationship: A Qualitative Multiple Case Study of Medical Specialist Enterprises in the Netherlands".
Int J Health Policy Manag
December 2024
Management Department, Opus College of Business, University of St. Thomas, Saint Paul, MN, USA.
The study by Ubels and van Raaij highlights the importance of alignment in hospital-physician relationships and the challenges in understanding, measuring, and managing it. Despite extensive research on alignment, drawing precise conclusions about its nature, drivers, and outcomes is difficult due to construct clarity and construct validity issues. This commentary focuses on clarifying these issues and the problems they create for hospitals attempting to manage alignment, as well as for scientific inquiry in this area.
View Article and Find Full Text PDFPhysician-hospital alignment: A definition and framework grounded in physicians' perception.
Health Care Manage Rev
November 2023
Unlabelled: The alignment of physicians' interests with those of their hospital has garnered considerable interest in recent years, in part because of their central role in health care expenditure and patient outcomes. However, the systematic study of physician-hospital alignment is currently impeded by a lack of construct clarity. This is evidenced by research that conflates the actions intended to create alignment with alignment itself.
View Article and Find Full Text PDFHow different governance models may impact physician-hospital alignment.
Health Care Manage Rev
June 2021
Lawton R. Burns, PhD, MBA, The James Joo-Jin Kim Professor, Department of Health Care Management, The Wharton School, University of Pennsylvania, Philadelphia. E-mail: Jeffrey A. Alexander, PhD, is Professor Emeritus, Department of Health Management & Policy, School of Public Health, University of Michigan, Ann Arbor. Ronald M. Andersen, PhD, is Wasserman Professor Emeritus, Department of Health Policy & Management, University of California-Los Angeles, California.
Background: Hospitals utilize three ideal type models for governing relationships with their physicians: the traditional medical staff, strategic alliances, and employment. Little is known about how these models impact physician alignment.
Purpose: The study compares the level of physician-hospital alignment across the three models.
Maximizing Physician-Hospital Alignment: Lessons Learned From Effective Models of Joint Arthroplasty Care.
J Arthroplasty
June 2018
Sidney Kimmel Medical College, Thomas Jefferson University, The Rothman Institute, Philadelphia, PA.
Background: With recent healthcare reform efforts focusing on rewarding value instead of volume, it has become important for orthopedic surgeons to partner and align with their hospitals. We report our experience in aligning clinical and financial incentives with 6 health systems in our geographic area.
Methods: By managing the entire episode-of-care continuum for total hip and total knee arthroplasty patients, our standardized, evidence-based protocols have improved the quality of care for our joint arthroplasty patients.
Single Institution Early Experience with the Bundled Payments for Care Improvement Initiative.
J Bone Joint Surg Am
January 2017
1Department of Orthopaedic Surgery, New York University Langone Medical Center, New York, NY.
The Centers for Medicare & Medicaid Services (CMS) implemented the Bundled Payments for Care Improvement (BPCI) initiative in 2011. Through BPCI, organizations enlisted into payment agreements that include both performance and financial accountability for episodes of care. To succeed, BPCI requires quality maintenance and care delivery at lower costs.
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