This resource offers you a unique Building Block system, a proven-effective tool used by organizations to survive and prosper in an era of different reimbursement schemes, from discounted fee-for-service and primary care capitation, to global capitation and percent of premium payment.
Today, with physician and hospital reimbursement being cut and tied to quality incentives, physicians and health plans are revisiting the concept of integration. Payers are demanding that the industry do more with less without sacrificing quality of care. As a result, physicians again find themselves integrating and aligning with hospitals that hav
"This book offers healthcare leaders a road map for the future and a clear vision of how employed physician networks must evolve to create strategic value. The authors help executives understand where they are on the journey to creating a high-performing group and recommend the priorities that must be addressed to move their group forward"--
The United States is facing a worsening epidemic of physician burnout with unprecedented numbers of them leaving the workforce and practice of clinical medicine across all career stages. The prevalence of physician burnout has accelerated through COVID-19, resulting in an anticipated serious national shortage of physicians within the current decade amidst an increased proportion of aging and unhealthy population. The critical shortage of physicians coupled with an unhealthy physician workforce results in longer wait times for access, continued increased healthcare costs, decreased quality of care, and worsening patient experience. Despite increasing media coverage, published data, and identification of system-based factors that erode physician wellbeing, no standardized systematic solution has been implemented across hospitals, health systems, or a variety of employment models or practice settings for any or all doctors regardless of whether they are primary care, medical, or surgical subspecialists. Effective solutions to mitigate physician burnout, protect current working physicians, and keep them from leaving medicine require a SHIFT and a more individualized approach. Many proposed academic models address system-based factors, but such solutions depend greatly on those who employ doctors. Executive leadership in charge of healthcare systems are often challenged by physician burnout and their desired autonomy, against the need for standardization of care delivery to improve quality and decrease cost. Physician productivity measures continue to be based on data samples of physician compensation surveys supplied by companies like Sullivan Cotter or Medical Group Management Association (MGMA). Such benchmarks are commonly used but data may not reflect specific realities for any organizations nor the rapid changes in the landscape of US healthcare amidst mergers, acquisitions, consolidation, and shifts in employment models from insurance and online retail giants and private equity. This book uses a "checklist" approach to empower any medical student, resident, fellow, or practicing physician to create and experience psychological, personal, and professional safety and wellbeing. Not only can individual physicians choose and use these checklists themselves, but those who live with, love, and cherish one or more physicians in their families and/or lives can use this book to understand physician realities and their risks.
This resource provides a concise overview of the techniques used to change physician behavior in a health industry ruled by newly-formed networks & under increasing pressure to remain cost-efficient, often in a capitated environment.Techniques used by managed care organizations from across the country will be highlighted.Topical summaries on key issues will include how to develop practice guidelines, how to win physician support, data gathering, liability issues, & probably most important, how to get started.
The Physician's Essential MBA: What Every Physician Leader Needs to Know is the essential resource for physicians who are seeking sophisticated business and managerial skills in order to survive in today's health care environment. This comprehensive text covers everything from change and strategy to effective data utilization.
This is the first reference book to provide a detailed assessment of the Affordable Care Act, explaining the realities and myths surrounding one of the most divisive political struggles in recent U.S. history. The Affordable Care Act—also known as Obamacare—is one of the most controversial and politicized topics in the United States today. This timely book examines prominent claims about the legislation's drafting, debate, passage, and implementation, and discerns what is true and false about the law. Each of the text's eight chapters delves into the common beliefs, misinterpretations, and myths surrounding the act, tracing the history of the assertion and supporting or challenging its veracity through nonpartisan research and analyses. Chapters begin with an objective look at the claim's origins—with a brief focus on the person or group that conceived it and why—then set about clarifying or debunking it using evidence from research studies and reports from authoritative sources. Entries feature primary documents, a further reading section, and tables and graphs. Topics include the impact on health care costs for families, states, and the federal government; the effect of the Affordable Care Act on employer-sponsored insurance; and the role of health status on coverage under the Affordable Care Act.