Shared-Risk Strategies

John Commins, for HealthLeaders Media , April 15, 2013
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This article appears in the April 2013 issue of HealthLeaders magazine.

In our December Intelligence Report on regulatory strategies, only 17% of leaders said their organization is fully prepared for the shift from fee-based payment to a shared-risk payment model, and while 48% say they are somewhat prepared, 36% acknowledge they are not prepared. What is your organization's strategic approach to this shift in payment models?

Deborah Zastocki, DMP, RN, FACHE
President and CEO
Chilton Hospital
Pompton Plains, N.J.

From our perspective, clearly what one needs to do to switch from the fee-based payment to a shared-risk model requires the proverbial alignment of interests.

We know you don't have to employ all physicians. That is a very costly model. One needs to have a repertoire of options for physicians. We have employed some of our physicians, and with other physicians we have assisted with recruiting for their offices to meet community needs. We have also done things such as management services agreements where we have used them in the comanagement of an office practice.

People are adopting one of a couple of strategies. One would be the wait-and-see approach and then jump on the bandwagon. Some others are like us and realize that the infrastructure that one needs to provide is not going to be as effective in our current models. So you have to be able to identify how are you going to be successful and, if it is not by yourself, then with whom and how.

With physicians in particular and the challenges and changes they are experiencing, it is very irresponsible and in some sense self-defeating to try to engage in a model that you don't know will be sustainable in the long run. To our physician colleagues it can be frustrating and impede collaboration. One of the things we all have to do is be flexible and adaptive as we go forward.

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