Outsourcing of physician talent is not just for the ED anymore. From the rise of hospitalists to anesthesia and beyond, companies with hundreds of physicians under contract are expanding their relationships with hospitals as goals for quality, patient safety, and throughput become more critical to maximizing reimbursement. Rather than building such accountability internally, hospitals are increasingly leaving the execution to companies that agree contractually to provide a certain subset of specialist physicians to the hospital. Many say that takes lots of administrative headaches away from senior leaders who have difficulty motivating and holding employed physicians accountable.
Companies that provide these services are increasingly gaining market share by being able to bundle subspecialties, and they’re looking for opportunities beyond ED, anesthesiology, and hospitalists—for example, with radiology, children’s services, or laborists, physicians who exclusively focus on obstetrics and deliveries in the hospital setting. Being able to combine these services is seen as a major plus. But the key to such companies is their scale, and their ability to allow smaller hospitals access to the technological support and organizational muscle of a large organization with hundreds of physicians.
Such companies are so attractive, many hospital senior leaders say, because they can often deliver better quality and safety for the patient, which equals better financial resource management for the hospital. It’s long been a truism in healthcare that when physicians’ goals are the same as the hospital’s, better, more efficient care results. Besides, it’s easier to fire a company that doesn’t meet such goals than to fire your own employed physicians.
To the uninitiated, such contracts mean hospital administrators are simply abdicating their responsibility to take direct control of physician behavior themselves. However, the trend might well allow smaller hospitals to survive in a competitive environment that is turning inexorably toward reimbursement based on outcomes.