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James Pizzo
Todd Fitz 

Playbook Elements

1. Define an operating structure under which newly acquired/affiliated physicians would operate and be integrated into system activities.

2. Develop a strategy to align the newly acquired/affiliated physicians with the broader physician community, including physicians who remain independent.

3. Develop a replicable practice acquisition program that clearly defines the process and timeline to acquire practices and employ physicians including due diligence, letter of intent, and deal closing.

4. Create a process to quickly evaluate and define the future operational and financial commitments that must be made to support physician initiatives.

5. Develop a consistent compensation model for acquired physicians, which will subsequently feed the financial model.

6. Develop a series of strategies outside of direct employment to offer to physicians who choose to remain independent.

Elements of a 100-day Transition Plan

1. Business considerations: Will there be restrictions on referrals (potentially changing referral relationships) and facilities used (i.e., network facilities only)?

2. Technology considerations: Developing seamless two-way information flow is one key advantage to be gained by physician practice acquisition. Will this be accomplished through a new or existing EMR? What investment in training and maintenance will the organization make? A responsive help desk is required for new technology.

3. Systems support: Will appointment systems, billing systems, and accounting systems be local or offered through a central office?

4. Contracting with payers: Will physicians move from signing their own contracts to control of this function under the organization's contracting office? Will risk incentives be offered?

5. Operating model: Will physicians be employed directly or through a tax-exempt or taxable subsidiary, an independent or joint-ventured entity, or a foundation?

6. Resource support: What will be provided in areas such as revenue cycle, facilities, and staffing (for example, flex options)?

7. Signage: For proper Medicare billing, every sign and bill must reflect the practices' new ownership on day one.

Source: Kaufman, Hall & Associates, Inc.


For more information, see James Pizzo and Todd Fitz's "Are Your Physician-Integration Strategies Sustainable?", hfm, November, 2012
 

Publication Date: Thursday, November 01, 2012

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