PYA’s expertise in organizational formation and operations, and their knowledge of healthcare reform has allowed us to accomplish an amazing amount of progress in a short period of time, said John Franks, FCHA executive director.
Knoxville, Tennessee (PRWEB) December 12, 2013
Building a clinically integrated network – or CIN - involving a hospital and community physicians – focused on quality, care coordination, and efficiency – does not have to be a long, difficult process, a white paper from national healthcare consulting firm PYA demonstrates.
“From Zero to CIN” helped Flagler Hospital in St. Augustine, Florida, and its medical staff design and implement their CIN in less than nine months. The Flagler project can serve as a roadmap for other community hospitals that want to establish a formal relationship with local physicians, says Martie Ross, a PYA Healthcare Consulting Principal and author of the white paper.
“Like most hospital boards, Flagler’s Board of Directors faced the challenges of foretold revenue reductions, threatened competition from nearby metropolitan health systems, and uncertainty about healthcare reform,” the white paper says.
“At the same time, payers and local employers were offering new opportunities. Payers proposed new contracts with innovative incentives: pay-for-performance rewards, network access fees, and shared savings payments. Leading employers were looking to the hospital for leadership on strategies to reduce their costs, including comprehensive employee wellness programs.”
The Flagler Board’s first step was to create a Clinical Integration Committee (CIC) and appoint physician leaders to it. The CIC was charged with making recommendations on how the hospital and community physicians could form and operate the CIN. With PYA’s help, education sessions were held and a nine-month deadline for contracting with payers was set.
“This tight timeline, driven by payers’ insistence on new payment models (and a desire for the CIN to participate in the Medicare Shared Savings Program in 2014) turned into a blessing rather than the anticipated curse because it kept all parties intensely focused on the process,” the paper says.
At a two-day summit, the 50 physician attendees reached consensus on the network’s governance structure. The workshop was very important because “the physicians left the summit believing in the possible, overcoming their doubts and reservations about working with one another and with the hospital.”
For the next six weeks, five workgroups, facilitated by PYA, met to hammer out details and make recommendations on the CIN’s governance, quality and operations, technology, communications and network development, and finance. At the end of this process the physicians on the CIC voted unanimously to recommend the workgroup report to the Flagler Board. The board then accepted those recommendations unanimously and committed financial resources to the network.
In June 2013, just seven months after the first education session with the medical staff, the First Coast Health Alliance (FCHA) was incorporated. Board members were elected, an executive director hired, and a response to the local school district’s request for proposal for a wellness program was written. By the end of July, FCHA filed its application to participate in the Medicare Shared Savings Program as an accountable care organization.
“PYA’s expertise in organizational formation and operations, and their knowledge of healthcare reform has allowed us to accomplish an amazing amount of progress in a short period of time,” said John Franks, FCHA executive director.
Ross said hospitals that are considering creating a CIN should: understand that education is the network’s “building permit;” empower physicians to lead the process; focus on building trust; set the expectation that physicians own the process; and create a step-by-step implementation plan that turns the scheme into reality.
In addition to Ross, Dr. Kent Bottles, Healthcare Advisory Services Principal; David McMillan, Healthcare Advisory Services Principal; and Jeff Ellis, Healthcare Consulting Principal, can be reached at 800-270-9629.
About Pershing Yoakley & Associates
PYA is a national healthcare consulting and accounting firm with clients in 48 states and the Virgin Islands and is celebrating its 30th Anniversary. It has more than 250 employees in its Atlanta, Kansas City, Knoxville, Nashville and Tampa offices and its five affiliate companies - Realty Trust Group, PYA Waltman Capital, Healthcare Horizons Consulting Group, MRG Medical Solutions, LLC, and PYA Analytics.