HCB News: Are we seeing EHRs being leveraged at this point in the game? What will it take to maximize that?
DB: Nobody could have expected providers to immediately become seasoned EHR veterans as soon as their systems were installed. Fast forward to today, and we’re much better positioned to more effectively leverage these systems.
Still, to attain an EHR’s full potential, providers need additional manpower and add-on technologies that integrate and present data from disparate sources in real time and trended over time — across the care continuum. But adding more technology and staff will just add cost if the underlying clinical integration foundation isn’t standardized. It’s the difference between a connected platform and a bag of apps. Before providers purchase these add-on solutions, leadership must make sure they have buy-in from employees – and clinicians in particular – on the added value these technologies will generate.
HCB News: Let’s switch to physician acquisition, a very hot topic at the moment. So many health systems are bringing in more physicians groups but there have been challenges. What are the dynamics at the moment?
DB: Many health systems are expanding physician group practices, and some through acquisition. But similar to the rest of the industry, issues like cultural alignment have made integrating acquired physicians a challenge.
Further complicating the situation has been the post-ACA advent of new players on the physician consolidation scene, including Optum Health and physician-staffing companies like Envision, TeamHealth, and MedNax. More recently, health systems have faced primary care group consolidation that’s increasingly backed by private equity-funded joint ventures, luring specialists with the promise of better means to care for patients and higher pay.
As a result, the rationale for physician employment has become a moving target for many health systems. Is it a market share/market growth strategy? A response to a competitor’s acquisitions? An ACO or “leverage the payers” strategy? And we talked a bit about how it just doesn't seem right that the defacto metric for physicians is loss per physician. That just doesn't sound like the road to a winning strategy.
To overcome this, health systems need to manage up the return on these acquisitions, rather than manage down the losses. A large portion of direct practice losses are a function of “hosting” practices, rather than effectively managing them. Post-acquisition, health systems often fail to take the steps to streamline staffing and support functions, leverage office locations, standardize supply chain purchasing, and optimize scheduling and care coordination.
