Meanwhile, Love says, more organizations will adopt employment models. “I’ve never believed in employment of physicians and now I look at it completely differently,” Love says. “Until we’re better able to partner with physicians in a way that is not risky [in terms of regulations], then we’re going to have to be looking at employment models to really make the continuum seamless and to support physicians.”
A potential barrier to provider collaboration is the
ability to effectively communicate and share data
with physicians as the patient moves through the continuum of care. Hospitals should take the lead in finding the best solutions.
“A Web-based portal system seems to be the best strategy,” Love says. “You’re able to follow patients in a much smoother way.”
Iowa Health System is a large integrated system, but it’s primarily made up of community-based hospitals and a network of employed and independent primary care physicians. It intends to stay decentralized, encouraging local autonomy and flexibility while setting clearly
“Each market, each region is the boss,” Leaver says. “You’re to do what is right and makes sense in your community. And you get judged and evaluated and rewarded on that basis. Our senior leaders feel like they have a lot of flexibility, ownership, and responsibility for what’s happening in their markets.”
Leaver says the ACO model is not, as some argue, an HMO by another name. “It’s very different, because the care coordination is happening with your doctor’s office. It’s your doctor who is taking primary responsibility for that care coordination, not the insurance company, not someone sitting in a call center thousands of miles away,” he says. “To us, that is a critical key difference that we think gives the model a higher probability of success with higher levels of patient satisfaction.”