Hospital/Physician Alignment and Clinical Integration

Gone are the days when the only way for physicians to “partner” with their local hospital meant to become an employee. The concept of strategic alignment has broadened and now affords a host of options for both physicians and hospitals. At Coker, we are experts at 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. While there are a number of ways to partner, many organizations are unaware of them and the benefits they hold. 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 initially providing education regarding the various models, their pros and cons, how they compare to each other, and in what situations a model suits best. Once we have a baseline of understanding regarding the alternatives, we help your organization determine the “best fit” for your current and projected needs. Next, and in concert with the client, our team documents the economic and non-economic terms of the preferred model for discussion between the potential partners. Finally, we represent organizations in their negotiations with a prospective partner to ensure the structure is a win-win for all parties.

Healthcare is rapidly changing, so organizations must move past antiquated models of alignment, expand their horizon, and adapt to new ways of working together. Having worked with both physicians and hospitals for more than 30 years and unceasingly looking forward, we are positioned to provide insights based on our keen and diverse experiences in all types of alignment work.

Beyond Alignment – Clinical Integration of Healthcare Providers

Many providers–healthcare systems, hospitals, physician groups–find that clinical integration is a viable vehicle for navigating the challenges facing the industry today. Clinical integration, however, is much more than alignment, and our advisors have the knowledge and experience to guide you through the development of a clinical integration program that will benefit all participants. We have supported the development of accountable care organizations (ACOs) as well as clinically integrated networks (CINs), and recognize them as a critical first step for any group of providers who wish to succeed in an environment that is inexorably moving toward pay-for-value and away from pay-for-volume.

Our approach to clinical integration includes:

• Education around the definitions of clinical integration and how this model differs significantly from alignment or affiliation models
• Guiding clients through the often-complex legal and regulatory requirements related to clinical integration
• Developing the organizational structure required by a clinical integration program
  • Governance – Care Management
  • Management — Information Technology
  • Finance and Accounting — Income Distribution Plans
  • Compliance — Marketing
• Developing the operational components of a clinical integration program
  • Data Analysis
  • Care Process Design
  • Process Improvement
  • Contracting
  • Measuring and Monitoring Performance
  • Peer Review and Accountability
• Creating a multi-purpose platform that is suitable for
  • Medicare ACOs
  • Medicare Advantage Programs
  • Commercial Narrow Networks