HFMA: Integration Takes Teamwork, Communication

From mini putting greens to magic tricks, there were many gimmicks to catch the attention of healthcare executives' attention this week at the Healthcare Financial Management Association's HFMA 2011 ANI conference in Orlando.

But, diversions aside, what drew healthcare leaders to fill the seats was the opportunity to interact with peers and to share practical strategies for contending with the serious issues we're all facing: reimbursement cuts, changing models of care delivery, and the need for technology integration.

In his keynote address, Monday, HFMA Board Chair Gregory Adams emphasized that the "days of the suits versus the white coats are over." This was one of the major overlying messages at the conference. And it's message healthcare marketers should take to heart: There is a great need to put egos aside and work together to solve common issues such as what to do about accountable care, how to improve patient safety, and how to recruit and retain physicians.

So how does this new language and teamwork system begin? As marketers we need to better understand how the leadership systems within our organizations work, in order to communicate better with both providers and patients.

At the IL-based Carle Physician Group, a large multi-specialty practice, the goal was to improve care efficiency and reduce costs by becoming a physician-led integrated delivery system. To save $40M in margin losses as a result of Stark laws, and to benefit from shared services, Carle Clinic Associates, Health Alliance Medical Plans, and the Carle Foundation formed one legal entity in 2009. Consequently, a new leadership structure was defined.

"We wanted true integration, not just in name only," said Dorrie Guest of Deloitte Consulting. "It was time to take your silo hats off and figure out how you are going to work together."

The first step was getting physicians on board and having them brainstorm ways to cut costs. The progressive steps that took Carle Physician Group, Health Alliance Medical Plans, and the Carle Foundation from separate entities to a single group look like this:

1. Competition
2. Cooperation
3. Collaboration
4. Co-management
5. Co-ownership

"Our biggest problem was the 'Tower of Babel' of diagnosis," said Bruce Wellman, MD, CEO of Carle Physician Group. "Physicians all had to agree on the same terms. We needed to get them to use a common language."

Wellman explained how the group hired five or six nurse navigators to help streamline the process of care and identify a common language. As a result, the 30-day readmission rate dropped to under 10%.

It's known that a physician-led model performs significantly better than non-physician led models in cost-efficiency, Guest explained. However, she said, "most organizations have not put enough money into physician leadership training in order for them to become sustainable leaders."

In the current financial climate, as many groups may consider becoming an integrated delivery system (IDS), they have to understand the level of effort involved.

Integration does not happen just with a name change, but with a change of leadership, communication, and collaboration. From a marketer's perspective, it's important to keep tabs on the leadership structure to market opportunities for physician leaders to step up and help run an organization.