"We're suggesting that if it's solely tied to a facility-centric model, you might find yourself not optimizing it in the end," he says.
Establishing a physician enterprise is harder to do than say. Also, until now, most organizations have been fairly successful with facility-centric physician enterprise, he says.
"It's very expensive, and it's not optimal, but for most part it has been profitable in the past," says Corso. "We think there's a better way, but you're not induced to that better way today."
Yet move away from fee-for-service reimbursement is changing that dynamic, if slowly. Not to mention that generally, physicians seize on the system-wide approach to managing their colleagues. They have an active role (or at least as active as they want to be, says Corso). That gives them a way to impact a practice.
"It's a big thing and they're still involved with the character of it. That environment will suit a system best," he says.
Still, transformation takes a long time.
"It involves a massive number of conversations, person to person, but it's worth the effort," he says. "If you have participatory governance, that's a better platform to work on as you build your physician engagement."