ABSTRACT
This commentary compares the current physician practice acquisition frenzy to that of the mid-1990s and reflects on lessons learned. The bottom line: Physicians must understand that there were no "white knights" in the 1990s, and there really aren't any today. This article delineates five main factors that both physicians and hospital executives should thoroughly explore and agree on before an alignment or acquisition. Agreement on these issues is the glue that holds the deal together after the merger. These factors eliminate both buyer and seller remorse and delve into the true cultural alignment that must take place as the healthcare industry addresses the challenges of the future.
Subject(s)
Delivery of Health Care/trends , Hospital-Physician Joint Ventures/trends , Practice Valuation and Purchase/trends , Attitude of Health Personnel , Commodification , Contracts/trends , Forecasting , Humans , Practice Management, Medical/trends , United StatesSubject(s)
Delivery of Health Care/economics , Fee-for-Service Plans/economics , Health Facility Merger/economics , Hospital-Physician Joint Ventures/economics , Antitrust Laws/economics , Antitrust Laws/standards , Cost Control/methods , Delivery of Health Care/organization & administration , Delivery of Health Care/trends , Fee-for-Service Plans/standards , Fee-for-Service Plans/trends , Health Facility Merger/trends , Hospital-Physician Joint Ventures/trends , HumansABSTRACT
The extent to which physicians lead, own, and govern accountable care organizations (ACOs) is unknown. However, physicians' involvement in ACOs will influence how clinicians and patients perceive the ACO model, how effective these organizations are at improving quality and costs, and how future ACOs will be organized. From October 2012 to May 2013 we fielded the National Survey of Accountable Care Organizations, the first such survey of public and private ACOs. We found that 51 percent of ACOs were physician-led, with another 33 percent jointly led by physicians and hospitals. In 78 percent of ACOs, physicians constituted a majority of the governing board, and physicians owned 40 percent of ACOs. The broad reach of physician leadership has important implications for the future evolution of ACOs. It seems likely that the challenge of fundamentally changing care delivery as the country moves away from fee-for-service payment will not be accomplished without strong, effective leadership from physicians.
Subject(s)
Accountable Care Organizations/organization & administration , Accountable Care Organizations/trends , Health Care Surveys , Leadership , Ownership/organization & administration , Ownership/trends , Patient Protection and Affordable Care Act/organization & administration , Patient Protection and Affordable Care Act/trends , Physician's Role , Forecasting , Hospital-Physician Joint Ventures/organization & administration , Hospital-Physician Joint Ventures/trends , Humans , Managed Care Programs/organization & administration , Managed Care Programs/trends , United StatesSubject(s)
Economics, Hospital/trends , Health Care Reform/economics , Health Care Reform/trends , Hospital Costs/trends , Insurance, Health, Reimbursement/trends , Cost Savings/trends , Delivery of Health Care, Integrated/economics , Delivery of Health Care, Integrated/trends , Forecasting , Hospital-Physician Joint Ventures/economics , Hospital-Physician Joint Ventures/trends , Humans , Medicare/economics , Medicare/trends , United StatesSubject(s)
Accountable Care Organizations/economics , Accountable Care Organizations/trends , Financial Management, Hospital/economics , Financial Management, Hospital/trends , Health Care Reform/economics , Health Care Reform/trends , Health Policy/economics , Health Policy/trends , Cost Control/trends , Delivery of Health Care/economics , Delivery of Health Care/trends , Forecasting , Hospital-Physician Joint Ventures/economics , Hospital-Physician Joint Ventures/trends , Humans , Insurance, Health, Reimbursement/economics , Insurance, Health, Reimbursement/trends , United StatesSubject(s)
Attitude of Health Personnel , Hospital-Physician Joint Ventures/trends , Medical Staff, Hospital/trends , Patient Protection and Affordable Care Act , Physician-Patient Relations , Age Factors , Hospital-Physician Joint Ventures/economics , Humans , Intergenerational Relations , Medical Staff, Hospital/economics , Medical Staff, Hospital/psychologySubject(s)
Ambulatory Care Facilities/standards , Health Facility Environment/standards , Hospital-Physician Joint Ventures/standards , Patient Education as Topic/organization & administration , Telemedicine/standards , Ambulatory Care Facilities/trends , Facility Design and Construction/standards , Facility Design and Construction/trends , Group Processes , Health Facility Environment/trends , Hospital-Physician Joint Ventures/trends , Humans , Patient Education as Topic/trends , Population Dynamics , Telemedicine/trendsSubject(s)
Fees, Medical/standards , Health Expenditures/trends , Hospital-Physician Joint Ventures/economics , Medicare/economics , Outpatient Clinics, Hospital/economics , Fees, Medical/trends , Hospital-Physician Joint Ventures/standards , Hospital-Physician Joint Ventures/trends , Humans , Medicare/standards , Medicare/trends , Outpatient Clinics, Hospital/standards , Outpatient Clinics, Hospital/trends , United StatesSubject(s)
Drug Discovery/economics , Drug Discovery/trends , Drug Industry/economics , Drug Industry/trends , Hospital-Physician Joint Ventures/economics , Hospital-Physician Joint Ventures/trends , Licensure/economics , Licensure/trends , Organizational Innovation/economics , Drug Industry/organization & administrationSubject(s)
Drug Discovery/economics , Drug Discovery/trends , Drug Industry/economics , Drug Industry/trends , Hospital-Physician Joint Ventures/economics , Hospital-Physician Joint Ventures/trends , Organizational Innovation/economics , Drug Industry/organization & administration , Government Agencies , Japan , UniversitiesABSTRACT
Before embarking on a physician-integration strategy, hospitals and health systems should perform a detailed analysis of the following four critical areas to ensure that the strategy is competitive and sustainable: Strategic objectives; Financial resources; Requisite experience and functional capabilities; Organizational structure, culture, and commitment.
Subject(s)
Cooperative Behavior , Hospital-Physician Joint Ventures/economics , Hospital-Physician Joint Ventures/organization & administration , Program Evaluation , Economic Competition , Efficiency, Organizational , Hospital-Physician Joint Ventures/trends , Organizational Innovation , Organizational Objectives , Practice Valuation and Purchase/economics , Practice Valuation and Purchase/organization & administration , Reimbursement, Incentive , United States , Value-Based PurchasingSubject(s)
Financial Management, Hospital/organization & administration , Hospital-Physician Joint Ventures/economics , Multi-Institutional Systems/economics , Outpatient Clinics, Hospital/economics , Financial Management, Hospital/trends , Hospital-Physician Joint Ventures/trends , Humans , Investments , Multi-Institutional Systems/organization & administration , Multi-Institutional Systems/trends , Outpatient Clinics, Hospital/trends , United StatesSubject(s)
Accountable Care Organizations/economics , Centers for Medicare and Medicaid Services, U.S./economics , Medical Informatics/economics , Quality Assurance, Health Care/economics , Accountable Care Organizations/standards , Centers for Medicare and Medicaid Services, U.S./standards , Clinical Coding/standards , Clinical Coding/trends , Cost Control/methods , Hospital-Physician Joint Ventures/trends , Humans , International Classification of Diseases/standards , International Classification of Diseases/trends , Medical Informatics/organization & administration , Quality Assurance, Health Care/standards , United StatesSubject(s)
Delivery of Health Care, Integrated , Hospital-Physician Joint Ventures/economics , Hospitals , Medical Staff, Hospital/trends , Physicians/economics , Delivery of Health Care, Integrated/economics , Economics, Hospital , Hospital-Physician Joint Ventures/trends , Hospitals/trends , Medical Staff, Hospital/economics , Salaries and Fringe Benefits , United States , WorkforceSubject(s)
Delivery of Health Care/economics , Health Care Reform , Health Planning Technical Assistance , Health Services Needs and Demand , Patient-Centered Care , Capitation Fee , Delivery of Health Care/statistics & numerical data , Delivery of Health Care/trends , Group Practice/economics , Group Practice/statistics & numerical data , Group Practice/trends , Hospital-Physician Joint Ventures/economics , Hospital-Physician Joint Ventures/statistics & numerical data , Hospital-Physician Joint Ventures/trends , Humans , Independent Practice Associations/economics , Independent Practice Associations/statistics & numerical data , Independent Practice Associations/trends , United StatesABSTRACT
It's been assumed, and now MGMA member stats bear it out--more and more practices are hospital-owned.