A new hospital is built. An ambulatory care facility is acquired. Your organization grows to include employed physicians and those in private practice in the community. Your health system or hospital network is growing, building new community relationships, and gaining patients. On the surface, it looks like a win-win situation.

In southeast Michigan, where the health care environment includes decreasing reimbursement from Medicare and Medicaid, increasing uninsured patients, complex compliance requirements and economic volatility, growth is both rewarding and challenging.

As Henry Ford Health System grew during the past decade, we were at times disjointed: new hospitals, employed and private physicians, competing interests and sometimes conflicting goals. And health care reform was knocking at our door.

To help stabilize and support the ongoing practice of value-based medicine, we needed to engage our 1,200-member Henry Ford Medical Group and our regional hospitals' employed and private practice physicians in common goals and reward structures.

The result was the creation of the Henry Ford Physician Network, a coordinated system of care delivery that aligns HFMG physicians, regional hospital employed physicians, private practice physicians, hospitals and ancillary services around new initiatives for clinical integration and quality improvement efforts. Development of the HFPN lays the foundation for an accountable care organization that will enable us to enhance the quality of care throughout the community.

At the core of the HFPN is clinical integration, a model of collaboration among physicians in a defined network to improve quality and efficiency. Our first step in creating the HFPN was to engage physicians — both employed and private practice — in early program development discussions. From there, we launched private practice physician recruitment at three of our community hospitals, and then moved recruitment to other regional hospitals.

Other initial work included aligning the HFPN with business units and departments to develop quality measures and programs that will form the foundation of clinical integration. Similarly, the health system's information technology team developed plans to deploy an electronic health record for use by HFPN and an ambulatory electronic medical record for private practice physicians.

To lead HFPN, we formed a board and work groups comprising predominantly HFMG physicians, regional hospital employed physicians and private practice physicians to direct the development of the network, services, quality measurements, referral management, accountability and incentive programs. The HFPN formally was incorporated as a new HFHS subsidiary in March 2010.

Thus far, we have nearly 1,900 members in the network, with more than 500 private physicians. The HFPN also allows HFMG physicians to collaborate with external physicians who want to enhance quality, efficiency and coordinated care delivery.

Through the new physician network, the HFMG is better aligned to create new clinical relationships, to engage in group contracting on a large geographic scale and scope, and to increase potential for greater reward and resources through earned incentives and value creation.

For us, this is the model of the future — true integration of all resources linked by physicians.

Robert G. Riney is president and COO of Henry Ford Health System in Detroit.

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