Fairfield, she says, only employs about 10% of the physicians with privileges at the hospital. And she's fine if it stays at about that level. She's also fine if it starts to creep up, but that will be dictated by market conditions, not by a free-for-all of recruiting inducements and salary guarantees that often come with physician employment.
"Everyone around us has their physicians employed," she says. "We're fine the way we are."
She concedes that many new graduates from medical school and residency programs are the ones who are currently seeking employment, but for now, the many joint ventures and other agreements she's signed over the years with physicians are doing just fine, she insists.
"We are not seeking to buy practices. Instead, we're doing a lot of work through co-management agreements to align with our staff, and that's going very well." With the uncertainty surrounding healthcare reform and the emphasis on work/life balance from new grads, however, she's open to employing them. The key there is in being selective.
2. You don't have to develop an ACO
Ubbing says Fairfield is operating under the philosophy that if it can manage and coordinate care for its own employees and bring down costs, there's not necessarily a driving need to focus so much on creating, or especially owning, the ACO structure.