The need for physician involvement.
Most health systems’ key initiatives depend on the involvement of its physician groups (both employed and independent). As the tool below illustrates, few steps in the journey toward population health management and health system sustainability can be made without direct physician involvement.
Different needs for different types of health system.
Physician strategies can vary depending on the characteristics of the health system. For example, the issues of an academic medical center involve a balancing of teaching, research and clinical responsibilities. Academic medical centers often have a need to solidify and bring closer their primary care referral base.
Aligned integrated systems, on the other hand, may have already carefully balanced primary care and specialists, but they may have difficulty expanding or accommodating other physician models.
Common differences between different types of health systems include:
Type Of System
Academic Medical Center
Strong potential for health system/physician integration
Insufficient primary care base
High cost structure
Aligned Integrated System
Tight physician/system integration
Advantages, real and potential, in population health management
Difficulty in expanding physician culture to accommodate new physicians and models
Scale economies (including potential cost spreading, population health expertise and systems, market coverage)
Flexibility in accommodating new physicians and models
Need to manage a wide range of physician models in varying markets
Stand-Alone or Rural System
Loyalty of local physicians
Lack of scale
Difficulty in building/maintaining specialty practices
High hospital support of physician practices
High cost of population health infrastructure
As more health systems consolidate, their physician issues will be a hybrid of the cohort examples shown above.