Provider integration — building a truly integrated network of physicians working toward the same strategic goals — is one of the largest operational challenges facing hospitals and health systems, according to a group of health care executives gathered at the American Hospital Association Leadership Summit on July 28 in San Diego.
As hospitals have aligned with physicians more closely over the last decade, various models of integration have emerged. Most health systems engage in various different models depending on the physician group, and each model has its own methodologies and metrics. The result can be a patchwork approach to aligning the organization around its strategic aims, which can falter without the right leadership, processes and transparency. There’s no denying it: Managing groups of physicians and the connections between them is extremely challenging. Yet, well-integrated provider networks are key to health system success: Coordinated care, high quality outcomes and patient satisfaction require near-seamless integration.
Given the numerous challenges that face integrated networks, athenahealth — the sponsor of the discussion with the executives and a provider of network-enabled electronic health record (EHR), practice management, and care coordination services — set out to better understand what distinguishes a high-performing health network from the rest of the pack.
Drawing upon customer data from more than 400 provider networks, athenahealth analyzed quality, patient satisfaction, physician experience and financial metrics to identify the highest overall performers. In partnership with with Harvard Business School professor Len Schlesinger, they then dug deep to understand the common characteristics of the high performers. What they uncovered was a set of 14 attributes that fall under three categories: leadership, physician and staff capability, and patient capability, explained Jasmine Gee, a director at athenahealth, who helped lead the discussion with the executives.
“It’s not actually about your systems; it’s not how you use your EHR or other IT systems; it’s about how you organize people and how you build processes,” she said. “It’s about foundational aspects of leadership, transparency, and intentional job and process design that enables provider and patient capability.”
The attributes include:
- Galvanizing vision
- Physician voice in leadership
- Principled growth orientation
- Hiring for fit
- Defined accountability structures
Physician and Staff capability
- Performance improvement resources
- Autonomy against clearly defined performance goals
- Radical transparency
- Strategic incentives
- Sustainable job design
- Focus on total patient experience
- Rapid access standards
- Multi-channel patient connections
- Effective processes for closing care gaps
A health system that exhibits each or many of these attributes is more likely to score highly on various metrics of success.
“Building high-performing provider networks takes a lot more than just adding physicians into your organization,” said Gee. “You really have to focus on how to make them capable. Do they understand the job they need to do as a part of the new organization? You give them the tools and the freedom they need to deliver a high-value experience.”