Success key No. 4: Overcoming conflicts
As hospitals establish relationships with physician groups to bolster physician networks, they must overcome the obstacle of potential conflicts and competition among the physician groups themselves, says Julie Manas, CEO of the 344-licensed-bed Sacred Heart Hospital and president of the HSHS Western Wisconsin Division.
In its highly integrated managed care market, Eau Claire, Wis.–based Sacred Heart has negotiated with two physician groups, a medical network, and independent and employed physicians. There are complicating factors that must be overcome to ensure a smooth working environment, including an overlap of specialties, competing interests, and direct competition, she says.
Sacred Heart Hospital is an affiliate of the Hospital Sisters Health System, a 13-hospital system based in Springfield, Ill. It is associated with the Marshfield Clinic, an organization of 730 physicians in 80 medical specialties and subspecialties located in 40 centers throughout Wisconsin. It is also affiliated with the OakLeaf Medical Network, a physician-directed health services network that includes 150 medical professionals in 41 physician offices.
Manas, who joined the hospital system within the past year, noticed early on that improved relations among physician groups were essential. Depending on the area of care, such as cardiology, "they are competitors against each other" in the hospital, Manas says. "I spend a lot of time meeting with executives and physicians. They see me as Canada or Switzerland, someone who is neutral. The point is developing integrated care," she says. These professionals work through any conflicting issues they may have with each other. "It has to be put aside, and they are doing that. It's about the patient, and when they are with the patients at the bedside, it's about all of us. That's what I have discussed with them, and it's working," Manas says.
A primary care physician network plays an essential role in improving those relationships and cooperation among groups, she adds. It was only in the past few years that the hospital expanded its network by adding independent physicians to employed doctors, according to Manas. "We now have employed physicians as well as independent doctors in the network, called the Physician Integration Network LLC." At least 200 physicians were involved in the program.
Earlier this year, the Sacred Heart Hospital and the Marshfield Clinic announced plans to jointly purchase and operate a local hospital and nursing home, with a local entity operating the nursing home for cost-cutting and overall quality improvements, Manas says. That plan could be traced to improved coordination established through the physician network, she adds.
"With primary care as the driver of care integration in our system, it is our belief we can do a better job," Manas adds. "We're not satisfied with just doing a good job. We want stellar."
This article appears in the October 2012 issue of HealthLeaders magazine.