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How to get physicians on board with your accountable care goals—in 3 steps

February 22, 2018

    Many of our readers have just put the finishing touches on their organization's strategic plan for 2018. And with tighter margins and more revenue at-risk than ever, one common provider goal for 2018 is to progress toward accountable care goals.

    This leads us to the hard stuff: getting the right people on board. One key place to start? With your physicians.

    Why your physicians need to be aligned with system strategy

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    Gaining physician buy-in on system goals is essential, as doctors influence up to 85% of all quality and cost decisions. And while a recent report by Bain and Company shows that physicians understand the challenges of delivering quality care with rising costs, they still want evidence that an overhaul in reimbursement and management structure will actually achieve this goal. In other words, planners need to earn their trust and motivation toward accomplishing these goals in order to achieve desired results.  

    One effective way to gain physician buy-in is to include them in decision-making. Not only is their input critical to informing clinical elements of the plan, but physicians involved in strategy development also tend to be more satisfied with their work environment and willing to lead change.

    Read on for three best practice tactics to improve physician alignment with the strategic objectives at your institution.

    1. Build trust in strategic efforts

    There's a strong imperative to increase transparency in the drivers behind organizational change:  Research shows a 40% increase in physician adherence when performance data is shared with doctors. However, even when data are shared transparently, providers still need to gain physician trust in the accuracy and representation of the data. Anticipate pushback on attribution of errors, data recording, results interpretation, and data selection—and preempt these concerns with transparency. For example, Montefiore Medical Center standardizes and centralizes data collection, and organizes regular meetings where physicians can voice concerns about metrics.

    2. Provide consistent feedback on performance toward goals

    Don't just provide consistent and continuous feedback to the outliers: Talk to your average performers, as well. Targeting outlier physicians can achieve near-term progress, but this provides limited and diminishing results as outliers are eliminated. By communicating with average performers, providers can achieve gradual behavior change from many physicians. This strategy requires a greater investment in time and effort, but provides greater return over time.

    3. Develop aligned incentive structures

    Consider designing alignment models that tie financial incentives to physicians' support of new goals. Transparency of included metrics is key.

    In the specific case of reducing care variation, for example, providers can tie payment to metrics related to care standard adherence. Providers could also consider rewarding physicians for time spent on care standard design teams.


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