Center for Healthcare Governance Monographs 2007

2007 - Hospital-Physician Clinical Integration

Overview:
As long as there have been hospitals; the topic of improving hospital-physician relationships has been a focus for trustees.

Today, however, the conversation has both a heightened sense of urgency and a wider scope of alternatives than ever before. An industry journal or a board meeting without some discussion about what physicians are planning, doing, or wanting is hard to find. Despite all the talk and ink, both physicians and hospitals are concerned that how they work together has not improved and both entities will be increasingly disadvantaged and at odds. This comes at a time when, new pressures are being exerted on providers, such as quality/outcomes reporting, reductions in professional and technical fee reimbursement, and a tightening of the regulatory belt.

If there is a single correct solution which hospitals should implement tomorrow, it has not yet been revealed. In fact, no “one size strategy” fits all. Most of today’s strategies are similar to the strategies employed in the late 1980s and early 1990s. However, the approach to implementing these strategies and ensuring their success in today’s market is very different.

That said, one new clinical integration model has emerged very recently that has been catalyzed, and is being advanced by, federal health policy. In October 2006, the federal government enacted a “Safe Harbor” policy related to the Stark Regulations, allowing hospitals to donate Electronic Medical Record (EMR) related hardware, software, Internet connectivity, and training and support services to physicians. Recipients of the donation must contribute 15 percent toward the donor’s cost of the items and services provided.

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