Hospital/Physician Alignment and Clinical Integration

  • Max Reiboldt, CPA

    Max Reiboldt, CPA



Strategic Healthcare Partnership Solutions: From Alignment to Clinical Integration

Gone are the days when the only way for physicians to “partner” with their local hospital meant becoming an employee. The concept of strategic alignment has broadened, now offering various options for both physicians and hospitals. At Coker, we specialize in analyzing, planning, and seamlessly implementing all forms of alignment and integration.

Hospital/Physician Alignment

Our alignment services encompass a range of educational and strategic components. Many organizations are unaware of the different partnership models and their benefits. The models include:

  • Pay for Call
  • Medical Directorships
  • Clinical Co-Management Agreement
  • Joint Venture
  • Professional Services Agreement
  • Non-traditional Employment
  • Clinically Integrated Network
  • Accountable Care Organization

We assist by providing education on the various models, their pros and cons, comparisons, and situational suitability. Once a baseline understanding is established, we help organizations determine the “best fit” for their current and future needs. Our team then documents the economic and non-economic terms of the preferred model for discussion between potential partners. Finally, we represent organizations in negotiations to ensure a win-win structure.

As healthcare evolves rapidly, organizations must move past antiquated alignment models, expanding horizons and adapting to new ways of collaboration. With over 30 years of experience working with physicians and hospitals, we provide insights based on diverse experiences in all types of alignment work.

Beyond Alignment – Clinical Integration of Healthcare Providers

Many providers – healthcare systems, hospitals, physician groups – find clinical integration a viable vehicle for navigating industry challenges. Clinical integration, however, is more than alignment, and our advisors guide you through developing a program benefiting all participants. We support accountable care organizations (ACOs) and clinically integrated networks (CINs), recognizing them as critical for success in a pay-for-value environment.

Our clinical integration approach includes:

  • Education on clinical integration definitions, distinguishing it from alignment or affiliation models.
  • Guiding through legal and regulatory requirements related to clinical integration.
  • Developing the required organizational structure:
    • Governance – Care Management
    • Management – Information Technology
    • Finance and Accounting – Income Distribution Plans
    • Compliance – Marketing
  • Developing operational components:
    • Data Analysis
    • Care Process Design
    • Process Improvement
    • Contracting
    • Measuring and Monitoring Performance
    • Peer Review and Accountability
  • Creating a multi-purpose platform suitable for:
    • Medicare ACOs
    • Medicare Advantage Programs
    • Commercial Narrow Networks

Questions? Ask an expert!

    Contact us today for more information about our healthcare consulting services and learn how we can help your organization.

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