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Coordinating Care Through Physician Outsourcing

Philip Betbeze, for HealthLeaders Media, February 13, 2011
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Jim Suver became CEO of 98- licensed-bed Ridgecrest (CA) Regional Hospital in February 2009. The rural hospital serves a population of about 27,000 and recently opened a new $76 million patient care tower, which added 43 beds. Getting the in-house physician teams right was critical, and they weren’t right when he arrived.

“We had a hospitalist group created quickly locally,” he says, explaining the change to an outsourced
model. “It was well-intended, but it just didn’t have the structure in it to provide seamless care to the patients. There were issues with communication between community docs and the hospitalists, and there was not a lot of work being done on core measures and patient satisfaction.”

The RFP process

Suver and his team put the contract for hospitalist services out to bid, which is increasingly the route most hospitals use when they’re looking to outsource a physician staffing need. But more and more, hospitals are looking to bundle the physician outsourcing they need—in other words, they want ED, hospitalists, anesthesia, labor, and other functions bid together. This decreases complexity in that the hospital’s goals and one company’s systems of care can be translated and optimized across a broad group of specialties that must communicate and work together to achieve quality and patient care goals. Ridgecrest’s ED was already staffed by TeamHealth, but Suver says he wasn’t necessarily committed to that company. However, its size and ability to staff a variety of specialties made a difference in the bid process, he says.

“Larger groups can bring in more support for the quality and patient satisfaction goals and it provides a margin of safety in that those goals can be written into the contract,” he says.

Incentives are aligned because the company grades its physicians on the same measures, and their compensation—and their continuing employment—is at least partly dependent on meeting those goals. Larger hospitals, Suver says, can actually save some money by keeping their hospitalist program, for example, in house, but in the end, the model he chose makes the most financial sense for his facility.

“I’ve actually had responsibility for running hospitalist programs in hospitals before,” he says. “There is an incremental cost to have a larger group take this responsibility, but with the component of resources they bring to bear, it more than makes up for those in-house cost savings.”

Ridgecrest made the switch in October 2009.

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1 comments on "Coordinating Care Through Physician Outsourcing"


Michael Eliastam (2/22/2011 at 9:34 AM)
It sounds like reinvention of the Medical Staff organization, but this time they are supposed to cooperate and collaborate. But nothing here sounds like its good for the patient, though i am sure it is good for the hospitals and the doctors. My very recent reports form patients in widely disparate sites, Burlington VT and Austin TX is that the system remains chaotic, and patients still do not know who is their doctor, seldom see their doctor in hospital, and communication between and amongst doctors is still as terrible as ever.