Each year, we talk with physician executives at health systems and medical groups to get their input on our research agenda. This process was even more important this year, given the impacts of Covid-19 on the health care landscape. From the rise of telehealth to volatile patient volumes to an increased urgency around health equity, care delivery has changed in many ways since this time last year. As physician executives look further into 2021, here are their top priorities.
1. Take advantage of the current level of collaboration within the physician enterprise.
Covid-19 united an increasingly diverse physician enterprise in new ways as physicians worked together to fight the pandemic. Both health systems and independent medical groups hope to harness that collaboration in 2021 as they turn their attention to evergreen priorities, like value-based care and ambulatory growth. To do so, organizations will need to refine their approach to physician alignment by tackling two questions: First, who makes up the physician enterprise, and do your alignment models help you achieve your shared goals? Second, how do you shape your culture in a way that brings together physicians under a range of alignment models, comprising multiple generations with distinct preferences and with increasingly more geographical dispersion? Answering these questions will be critical to ensuring that the gains made in unity as a result of Covid-19 persist beyond the pandemic.
2. Don't just rely on pre-Covid-19 burnout solutions. Instead, develop a comprehensive burnout strategy geared toward recovery.
Burnout is an evergreen challenge facing the physician workforce, and the pandemic layered on new stressors and trauma. As physicians were on the frontlines, executives intentionally reduced some pre-Covid burnout triggers. But nearly a year into the pandemic, those administrative burdens are returning, and daily traumas are taking their toll. Now is the time for executives to develop a comprehensive post-Covid-19 recovery strategy that promotes physician recovery and does not over-rely on reverting to pre-Covid norms. To do this, look at your support services holistically to identify gaps in the accessibility, breadth, and depth of support. Then, build on and sustain new innovations you've stood up during the crisis to round out a robust burnout and recovery strategy.
3. While you may be eager to make progress on your health equity goals, start by better understanding where to target investments.
From Covid-19's disproportionate impact on communities of color to a national reckoning with systemic racial injustice, the events of 2020 brought health equity to the forefront of executives' minds. But health inequities are complex, multifaceted, and structural in nature and go far beyond racial identity—making them difficult to identify and tackle. While executives are eager to equip physicians with the knowledge and tools to refer patients to the right level of support consistently, many are still trying to grasp where they are falling short. Instead, prioritize tracking both institution-specific and community-oriented metrics to target future investments. A thorough analysis of this data will identify if and how existing initiatives are making progress on reducing disparities and help you design future initiatives to address the needs of groups experiencing disparities.
4. Design compensation and care delivery processes that equip physicians to succeed under hybrid business incentives.
While Covid-19 didn't spur health systems to transition fully to risk, it did create financial pressure to seek out alternatives to fee-for-service revenue when faced with lower volumes and higher costs. This has brought them more in line with independent groups, which historically have had more revenue tied to risk and more experience in value-based care. Going forward, health systems and independent groups will continue to have a hybrid incentive mix of fee-for-service and fee-for-value payments. Now is the time to define the role of both primary care and specialty physicians who practice in this dual payment model world. Then, prime physicians for success in this world by making value-based care decisions simple and implementing incentive models that will succeed in this new paradigm.