ACOs Shine Spotlight on Physician Employment

Carrie Vaughan, for HealthLeaders Media , May 10, 2011

In addition, physician practices that have been dependent on ancillary revenues to ­support physician compensation are being ­negatively impacted by reimbursement changes, says Hickman. These practices, such as ­cardiology and oncology groups, are looking at how they can ­realign with healthcare systems.

"We need to reorganize ourselves in a way to really tackle community health from a quality, cost, and efficiency perspective," says Stephen Moore, MD, senior vice president and chief medical officer (CMO) at Catholic Health Initiatives (CHI).

To that end, CHI, a nonprofit health system with 73 hospitals and 40 long-term care, ­assisted- and residential-living facilities, ­announced in March the appointment of T. Clifford Deveny, MD, to the newly created position of senior vice president of physician practice management. The Englewood, CO-based organization's goal is to significantly expand the number of employed physicians from approximately 1,500 to more than 3,000 in the next two to three years.

"We need to have a secure base of physicians from an employment perspective as well as a cadre of community doctors through other contractual arrangements in order for us to align all the incentives from a regulatory to legal and compliance standpoint," Moore says.

The health system plans on having 65% of its net patient service revenue come from outside the acute care hospital and be able to fully manage the risk of community populations-with the help of data analysis tools-by 2020.

Small physician practice gives up the reins
Endocrinologist Karl David McCowen, MD, founded Tacoma, WA-based Endocrine Consultants Northwest in 1980 and became part of Franciscan Medical Group (FMG) nearly 30 years later in 2009. There was a perfect storm of conditions that led the practice, which included three ­endocrinologists and one nurse practitioner, to seek employment, McCowen says-namely, the diabetes epidemic, difficulty recruiting, and pressure to adopt EMRs.

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