Physician leadership was a recurring theme at the National Association of Managed Care Physicians conference in Orlando, which I recently attended. Indeed, the topic is becoming more prominent at a number of conferences focused on preparations for healthcare reform.
At the conference, Pennsylvania's Independence Blue Cross shared its success with several value-based payment models that it has developed in recent years. One of IBC's main objectives for implementing these models is to re-empower primary-care physicians. But being part of the value-based model isn't easy. To participate in IBC's accountable care payment model, the providers were required to develop and submit a performance improvement plan specific to their respective practices. IBC required physician engagement and thought as representatives from the insurer said, the doctors couldn't just join the program and get their bonuses. IBC recognized the importance of engaging physicians in the process of their payment reform initiatives and knew that it would be key to success.
Other speakers at the conference also emphasized the importance of physician involvement, despite the fact that the topics of their sessions varied widely. It was mentioned in the context of ACO development that physicians need to be the internal champions of implementing accountable care initiatives for the other physicians within their organizations. It also came up in a presentation on health information and data tracking; physician champions were listed as a key to success for the disease management case study that was featured.
One week later, health system executives at the annual meeting of the American Hospital Association in Washington, D.C., also touted the importance of physician engagement and involvement. Among them were executives from three systems participating in different models of CMS's bundled payment initiative (Vanderbilt University Medical Center in Nashville, Christus Santa Rose Health System in San Antonio, and White County Medical Center in Searcy, Ark.); all listed physician leadership and engagement as the key to success. Vanderbilt has bundled payment teams that are led by physician co-champions. When physicians are put into these leadership positions, they have a much better platform to convince their skeptical and sometimes resistant colleagues of the necessity for the changes (FierceHealthcare).
Physician engagement and involvement is critical for many of the changes currently facing the healthcare sector, especially as we move toward a system that relies on sophisticated information-sharing and rewards providers for quality and outcomes rather than volume. Whether a health system decides to develop an ACO, an insurer begins offering incentives for patient-centered medical home recognition, or a physician group begins implementing an EMR system, all require significant physician involvement. In fact, numerous leadership positions are created simply by undertaking these initiatives, so physicians are provided with an immediate opportunity to step up and lead.
The role of physicians is becoming increasingly critical not only because they will be expected to better manage their patients health, but also because they will need to be advocates of these initiatives among their peers. Many of these changes may require a great deal of adjustment for physicians, who must convince their patients and their fellow providers to embrace these changes so that both groups can begin benefitting.
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