Physicians Managing Costs

This article appears in the January 2012 issue of HealthLeaders magazine.

As hospital systems restructure their cardiology programs, many have enlisted physicians to oversee clinical programs, which is expected. But physicians as cost-control managers?

That's what the Wellmont Health System in Kingsport, TN, an eight-hospital system in Virginia and Tennessee, has developed to improve coordinated care, especially with potential accountable care organization involvement, says Tim Attebery, system vice president of cardiovascular services.

The Wellmont Health System runs a comanagement system with physicians and administration. "Physicians have an incentive to help the hospital," Attebery says.

Wellmont is preparing for changes in the post-healthcare-reform environment and negotiating with cardiology physician groups in ACO planning. "We are saying, 'Let us sit at the table when you are designing and creating a plan, and we'll be there with you,'" Attebery says. A major area of concern is to "share the risk for cost performance."

As they evaluate ACO structures, "the most important thing is to develop systems of care, care coordination, and a cost management system," Attebery says.

It is important for systems to evaluate a "culture change" in an ACO environment, he says.