As the healthcare industry enters another year with rising costs and declining revenue growth, providers are scrutinizing their operations to rationalize their cost structures and maximize all potential sources of new revenue. Ideally, hospitals and health systems will deliver value to their patients – higher-quality care and a positive experience – while decreasing resource consumption.
There are several levers for organizational leaders to pull as they aim for improved margins, whether it’s reviewing the cost of high-value implants or moving toward an optimized care delivery model. And in all aspects of transformation, there is one group of stakeholders whose engagement is crucial to their success: physicians.
Physicians drive service line initiatives, recognize their peers’ and patients’ needs, and can act as champions who solicit participation from other clinicians and staff hospital-wide. So, naturally, commitment from this group is critical. Part of the challenge is that providers juggle multiple priorities when delivering care – from reframing their practices around new performance goals and payment models to managing an increasing number of patients – and many providers may resist transformation initiatives that feel like a distraction from their daily workload.
The right data and incentives enable physicians and leaders to join forces and lead transformation together.
To gain genuine participation in transformation initiatives, physicians should be engaged early alongside organizational leaders to jointly identify areas of opportunity and validate both quantitative and qualitative information that will guide the work. In other words, physicians need to have a place at the table to determine priorities and where organizational resources should be focused.
Credible data that includes internal and external performance benchmarks can often lay the groundwork for physician buy-in. For leaders, a good starting point to engage physicians would be the use of analytics that integrate quality and financial data.
With the right data in hand, leaders should present the information in a manner that resonates with physicians. While it’s beneficial to stratify the data by financial opportunities, physicians first need to agree that the data is accurate and meaningful. Allow physicians a chance to ask for more detail or to provide input on how to refine the analysis. This analytical work could result in data views that illustrate to physicians whether the organization is meeting top-quartile benchmarks, how variation in patient care is leading to less predictable outcomes or excessive versus appropriate testing.
Finally, organizations shouldn’t be afraid to use meaningful incentives to support participation from physicians and leaders in transformation initiatives. The benefit of incentivizing both parties is that it increases the likelihood that results will be achieved. Developing a meaningful incentive program requires physician input as well as a careful selection of metrics that align with organizational priorities and goals.
Four methods to successfully engage physicians in transformation initiatives.
Once physicians validate the data and agree that opportunity exists, they are often naturally motivated to figure out what’s driving variation. Effective leaders can help provide guidance in four ways.
1. Level-set on the why.
If senior leaders are embarking on a transformation initiative to drive improvement, it’s imperative that they message why the organization is committing resources and time toward this change. They can relate the actions and strategies back to the institution’s core mission and vision, underscoring how this work affects patients, providers and staff, as well as margin improvement.
2. Incentivize physicians with a focused vision and carefully select metrics together.
Leaders should lay out a clear vision for what they’d like to accomplish and approach physicians as collaborators and business partners who have a shared interest in seeing these efforts succeed. Effective alignment derives from a partnership and emphasizes the experience of working together to meet objectives. Physicians are often able to illustrate how organizational changes may touch areas with unintended consequences (i.e., quality, clinician satisfaction or patient satisfaction).
Therefore, it’s important for leaders to maintain a balanced approach with improvement efforts and continue to measure outcomes against cost, quality, service and satisfaction metrics. Once objectives are aligned, the next step for leaders and physicians is to determine the results that need to be achieved and to select the metrics they will track to measure the improvement.
3. Leverage business intelligence to focus attention on the top financial opportunities and let physicians decide which they would like to tackle.
Rather than approaching physicians with a fix for an issue, leaders should supply opportunities and allow physicians to apply their clinical expertise and ideas to drive a solution. Consider presenting the top financial opportunities as a performance improvement menu, providing physician’s choice and ownership while reiterating how the work relates to financial improvement. A good way to ensure collaboration is by saying, "Here is the data that shows we have a variance. Can you help me better understand it?"
4. Rethink how clinical efficiencies can affect patients.
Some individuals may still evaluate their practice through a fee-for-service lens, viewing testing and volume as a revenue generator for the organization. Leaders need to frame the organization’s new approaches as guidance to help individuals make informed decisions based on the best interest of the patient, while balancing revenue considerations. As an example, a review of pre-discharge testing may identify unnecessary tests that delay the discharge for patients. Engaging physicians in these conversations can help identify areas of opportunity that result in improved efficiencies.
Ensure the new initiatives stick.
As physicians and staff undertake new strategies to optimize care delivery and improve margins, it’s important to hardwire changes into both daily workflow and supporting technologies. Doing so can help ensure that systems and measures provide visibility into the effect of these changes, ultimately resulting in sustainability. A strong clinical decision support program helps remove the guesswork by ensuring proper application of evidence-based care.
While every healthcare organization’s culture is different, it’s difficult to imagine successfully navigating the complexity of industry change without physicians at the center. And if experience tells us anything, it’s that the best strategies are often a result of successful collaboration and shared decision making across physicians and organizational leaders.
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