In today's healthcare industry, many physicians are making the transition from smaller practices with one or two partners to becoming a practitioner within a hospital where they are managed as part of a much larger organization. To shed light on this issue, I shared my insight and advice in an interview for a blog post for PreCheck, a provider of background screening and employment qualification services for the healthcare industry, on how organizations can develop highly engaged physicians.
A few vital pieces of information from the post:
- Healthcare organizations should run engagement surveys on a regular basis. Physician engagement can be measured with a wide variety of metrics that will depend on the organization's survey firm.
- Perceived competitiveness and quality of leadership are frequently key engagement drivers for physicians. In today's healthcare climate, there's a certain level of apprehension toward the direction of the industry, so physicians tend to be more or less engaged depending on their organization's leadership and rank.
- Healthcare organizations should examine their communication strategies. It's critical for an organization to find ways to ensure employees are aware of the competitive projects they're involved in and prevent miscommunication.
Click here to read the full post titled, "How Healthcare HR Can Develop Highly Engaged Physicians."
At INTEGRATED Healthcare Strategies, we know the performance of your organization hinges on the engagement of key groups and how they impact your business. Our team of dedicated consultants provides measurement solutions for key members of your organization--the people who influence the patient experience and long-term success. Invite one of our senior consultants to give you a call--no obligation--at 800.821.8481.
Earlier this year, the IRS finalized proposed regulations under Section 83, which means programs relying on Section 83 should be reviewed and modified as necessary. The new regulations could result in some organizations having non-compliant benefit plans, and non-compliance can result in tax penalties.
Additionally, many not-for-profit organizations use non-qualified deferred compensation programs to enhance executive retirement benefits. Some of these programs utilize the transfer of property provisions under IRS Section 83 to defer taxation. Deferred compensation within life insurance policies is one of the most common programs using this structure.
With the IRS finalizing the proposed regulations under Section 83 in late February 2014, programs relying on Section 83 should be reviewed and modified as necessary.
Section 83 Changes
Section 83 governs taxation when an employer transfers property to an employee. For taxable employers, Section 83 often governs stock-based compensation. For non-profit healthcare employers, Section 83 applies where, for example, the employer pays premiums on a life insurance policy owned by the employee, and the employee forfeits the policy by competing with the employer.
The old noncompete standard was fairly easy to meet; the new standard is not:
- Old Standard—A noncompete will defer taxes if the employer is likely to enforce the forfeiture if the executive competes
- New Standard—A noncompete will defer taxes only if the employee is likely to compete
For more details and to learn whether or not your organization qualifies for deferral under the new standard, visit our Knowledge Center to download the summary document. If you need assistance navigating current and expected law changes for your plans, contact our Total Compensation & Rewards team at 800.327.9335.
What is impacting your clinical staffing ratios? Are those impacts within benchmark range?
Many physician practices do not take the time nor make the effort to "right-size" their clinical support staff in the face of either external or internal changes in the practice. Recently-trained physicians joining the private practice may feel the need for the level or type of clinical support staff they had in their training program. The costs of that support, however, may not have been justified by the activity level or revenue received per visit. Additionally, senior physicians in practice may not feel comfortable in the office without their regular nurse, despite spending little time in an office setting.
Conversely, the lack of a balanced clinical support staff can lead to poor patient service and inhibit patients from accessing proper care. The key in both cases is to revisit the rationale for the type of clinical support staff to ensure both financial and clinical issues are considered and that any "right-sizing" takes place in a thoughtful manner.
Recently, INTEGRATED performed an Operations Assessment for a client that revealed their overall nursing support staff to be at or above the benchmark media. Their staff, however, felt overwhelmed by the workload and couldn't keep the pace with the increasing demand from patients along with returning phone calls. Their preferred solution was to hire an additional staff member to take care of the additional workload. INTEGRATED was able to identify process changes that led to more efficient use of the nursing staff's time. The practice's physicians and staff supported the changes and the organization was successful in avoiding the added cost of hiring.
At INTEGRATED Healthcare Strategies, we have a team dedicated to Physician Practice Operations. Their entire focus is on measuring, benchmarking, and improving operational performance. If your practice struggles with optimizing operations with the right staff, invite one of our senior consultants to give you a call--no obligation. They're well-equipped to spend time assessing the situation and give you their initial impression.
“We are unique, so finding a benchmark for us is impossible!” If you’ve heard this once, you probably have heard it a thousand times! Even worse, if you’ve said this once, it was probably one too many times!
In the healthcare industry, the concept of individualized patient care is natural. But that doesn’t mean we don’t do diagnostic tests and compare the results to what is considered “normal” ranges for similar patients? Healthcare providers benchmark patient care all of the time – yet still create an individualized care plan for each patient’s specific needs. Why would we approach the health of the practice any differently?
It isn’t uncommon that we encounter a client program where benchmark data truly doesn’t exist. In these cases we don’t stop trying to help the client improve. After all, we know what “better” looks like without a benchmark. So, driving improvements in the absence of benchmark data, starts with an assessment of the “current state” of the program with common metrics. The next step is to envision what the “future state” will look like, quantified in terms of those metrics and allowing for the gaps to be identified. Then, through rapid cycle improvements targeted at those gaps, we make changes and re-measure to determine impact.
The concept isn’t new. It is the scientific method, the same methodology that drives medical advancements.
We have often seen a practice with performance that benchmarks well ahead of its peers, sustain a false sense of accomplishment, resulting in performance below potential. Conversely, we have seen practices with performance well below benchmark, lose enthusiasm for improvement because they see how far they are behind, how far they have to go. So even when benchmark data is available, measuring impact of change relative to previous performance will never lead you astray in your quest for optimizing your practice’s potential.
Benchmarking with out benchmarks? Sure! You should do it all the time!
In today’s healthcare environment, two things are driving an increase in organizational risks: a reduction in payments and a transition to a value-driven system. The real challenge today is how to best move forward.
Accountable Care Organizations (ACOs), provider organizations that assume some financial responsibility for maintaining the health of a population, present an important challenge. The most widely used ACO is Medicare, which has a financial arrangement for sharing risks and rewards.
Recent medical school graduates with large amounts of debt also present a challenge associated with an increase in risk. Many are not willing to accept risk themselves, but are willing to work for an organization that will assume and help mitigate risk.
Undoubtedly, each organization and market poses different opportunities and challenges associated with managing the declining reimbursement and increasing risk paradigm. It’s important, however, to take a step back and envision the desired state of the organization or market in five to ten years, realistically think about the external world’s impact, and confront the facts internally. Some recommended internal steps include:
- Performance improvement
- Lead with quality
- Physician extenders
Watch the three-part video series, “Raising the Bar,” featuring Don Seymour and Dr. William Jessee, to further learn how to thrive in today’s evolving healthcare environment.