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Beyond Costs: The Value of Comanagement Agreements

Karen Minich-Pourshadi, for HealthLeaders Media, May 13, 2011
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Regardless of facility size, establishing metrics is a key to successful comanagement agreements. For Dennis Jack, president and CEO at the 25-bed Golden Plains Community Hospital in Borger, TX, these
agreements mean providing the community with badly needed emergency department doctors—physicians who are hard to come by due to the hospital’s rural location. 

With $16 million in net revenue last year, Jack says his for-profit, critical care hospital, as well as its three clinics and home health site, have established several clinical comanagement agreements for various specialties to help offset the region’s physician shortages.

“In our ED we wanted to work with a company that has the same goals we have. And that they would monitor the areas we wanted to improve, such as the length of stay and the throughput of the visit. We are planning to make that metric part of our contract next year and it will be tied to the doctor’s bonus,” he says.

“It’s hard to find doctors to employ here and even harder to find consistent, good quality ones,” Jack says. “The company we partnered with brings us those doctors, and if we do have a problem with a physician, we can get them out of our hospital on the same day and have someone else in the next day. You can’t do that when you employ a physician.”

In creating comanagement agreements for Golden Plain, Jack says, “What we’ve found is that the physicians have to have skin in the game. You have to include some cost factors and metrics as well as measure the patient satisfaction. For instance, with our sleep lab contract, we made patient satisfaction scores a focus—at least 80% of the patients need to be satisfied with their experience or we can end the contract.”

Comanagement agreements also can be used to test the viability of an eventual physician and hospital partnership or full employment. At the 43-staffed-bed Aspirus Heart and Vascular Institute, part of the 200-staffed-bed Aspirus Wausau (WI) Hospital, Scott Garavet, cardiovascular service line administrator, used a clinical comanagement agreement to enhance its cardiology offering.

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