Your compliance system has a leak.
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May 16
Medical Group Value Walks Out The Door
As much actual tension as there is between physician groups and ACOs, they share a common weakness.
From the smallest multi-provider group to the largest “alignment” entities, their real value isn’t in leases, equipment, or payor contracts, it’s in the knowledge, skills and experience of their professional employees – specifically, their physicians.
That value walks out the door every evening. There’s no guarantee that it will return in the morning.
Continued “loyalty” must be earned, not assumed, and can be temporarily assured only so long as you have taken steps to create legal structures within which to hold it.
For hospitals and their ACOs, the issue is bleak, as the dynamic is generally different from that between physicians and physician owned groups. Costing millions to structure and many more to operate, it’s likely that ACOs will be unable to retain their physicians long term — at least their excellent physicians — as their attempts to treat physicians as fungible will lead to many physicians considering the relationship as fungible. What if you built an ACO and physicians came, but then left?
For physician group leaders, this means a comprehensive program to retain the right employees, from creating the proper practice culture to incorporating provisions within employment agreements that provide both incentives and disincentives designed to encourage the longevity of the relationship. Even in states with strict policies against enforcing covenants not to compete, other, sophisticated legal strategies can be employed.
Comment or contact me if you’d like to discuss this post.
Mark F. Weiss
May 14
Physicians As Antiquated As “Books Printed On Paper”
While on a website obviously aimed at the college student age group, I noticed an ad for a book by a well-known author. Below a picture of the book’s cover were the following words: “All of the words, printed on paper. Classic!”
This is an interesting signpost of the impact of what Joseph Schumpeter called creative destruction: Although e-book sales are growing dramatically, printed book sales, whether online through Amazon and its few competitors or at the remaining local bookstores, remains a vibrant business. But how long will that be the case if the next generations of readers find the notion of physical books quaint.
In similar fashion, how many patients will soon accept the notion that seeing a physician, as opposed to a technician, as antiquated?
As you’re engaging in your Scenario Survey Process™, consider that as a highly possible future. Although it appears dark, there is light at the end of that tunnel for certain segments of the market and for certain physicians who desire to remain relevant in the context of patient care as opposed to in the supervision of physician extenders.
Comment or contact me if you’d like to discuss this post.
Mark F. Weiss
May 11
What League Are You In? – Podcast
Why are you convinced that you have to work your way up the ladder step-by-step?
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May 09
The Impact Of Change On Your Medical Practice
The common belief, and it may be quite true, is that change is the greatest cause of stress. But what if it can be used to your group’s advantage?
In the mid 1980’s there was a well known West Coast billing service that told its clients that they had only follow three simple rules to obtain success: Do the cases. Turn in billing information. Go home. Then, they would be paid.
Fast forward to today. Far too many physician groups have a business model based on that same philosophy. As the writer Robertson Davies said, “The world is full of people whose notion of a satisfactory future is, in fact, a return to the idealized past.”
Today, it seems as if change is accelerating at a faster and faster pace: ACOs, government interference, fraud and abuse witch hunts, your services as someone else’s “right,” national groups poaching your opportunities, hospital-centric healthcare, and a “system” not a market – these are just some of the bats hitting you as you run the gauntlet of daily practice.
But change in the healthcare industry has always been a given. It’s how you and your fellow group members react to the change that makes the difference.
If the change is feared – the fear of the unknown – then indeed it is a major cause of stress. So,if your group does nothing but engage in business as usual, then you will undoubtedly be victim to the winds of this change and, eventually, will be shipwrecked.
On the other hand, if you view the winds of change are presenting new opportunity, the opportunity to enage in practice in a way that previously, for ethical reasons or image reasons or economic reasons, was viewed as inappropriate, then change changes from fear to fuel.
The French got it wrong: The more things change the more things change. Use change to your advantage, to your success, and to your profit.
Mark F. Weiss
May 07
Using The Scenario Survey Process At The Micro Level
In my podcast How Scenario Surveys Strengthen Group Strategy, or in my article by the same name, I discuss the importance of your use of the scenario tool in setting group strategy.
There’s another aspect of the Scenario Survey Process that’s important for any physician group that negotiates with a hospital, the classic example being the exclusive contract situation. That aspect is the use of the scenario tool at the micro level, for example,consideration of the various scenarios that can exist in terms of the personnel and relationships at a facility.
Take the instance of a group that has a tremendous relationship with the hospital’s CEO, with whom it negotiated five straight three year deals. What would be the impact of the CEO’s retirement?
As the earlier podcast and article stress, the Scenario Survey is essentially a large scale, macro planning tool. That doesn’t mean that it can’t also provide meaningful insight when used to drill down deeper into your group’s situation.
Comment or contact me if you’d like to discuss this post.
Mark F. Weiss
May 04
Yin and Yang. Contract Term And Termination. – Podcast
Your contract’s real term is how quickly it can be terminated.
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May 02
Potentially Profitable Interplay Between Exclusive Contracts and ACOs
There is a complex interplay between hospital-based group exclusive contracts and ACO-entity payment mechanisms.
In addition to making certain that money flows into the group, as opposed to around it, obviously a protective move, there are significant planning opportunities in the play off between the managed care contracting provisions of exclusive contracts and the terms of hospital-controlled ACOs.
Things have become far more complicated but there are potential opportunities that you must exploit.
Comment or contact me if you’d like to discuss this post.
Mark F. Weiss
Apr 30
In Loco Parentis, Or Just Plain Loco?
Growing up in the 1970s, parents urged their children to go to school, get a degree, and then work for a great company. Even kids who went into factory jobs heard a similar version of this story. You’d be set for life — the security — or so the story went.
Then came “right sizing” mass layoffs, business failures, and the winds of creative destruction that drove jobs offshore.
My point in this is that there is no real security in depending upon a pseudo-parent employer.
So why are so many physicians falling for this same story in regard to hospital employment?
Wake up. They’re not fooling you; you’re fooling yourself.
Sorry, it’s tough love. And, I’m not your daddy.
Mark F. Weiss
Apr 27
I’d Rather Go Somewhere Else – Podcast
You need to hire for more than clinical competence or even clinical excellence.
Podcast: Play in new window | Download
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