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Physician Alignment: Constructing Viable Roadmaps for the Future [Kietas viršelis]

  • Formatas: Hardback, 157 pages, aukštis x plotis: 234x156 mm, weight: 408 g, 1 Tables, black and white; 52 Illustrations, black and white
  • Išleidimo metai: 26-Nov-2012
  • Leidėjas: CRC Press Inc
  • ISBN-10: 1466504765
  • ISBN-13: 9781466504769
Kitos knygos pagal šią temą:
  • Formatas: Hardback, 157 pages, aukštis x plotis: 234x156 mm, weight: 408 g, 1 Tables, black and white; 52 Illustrations, black and white
  • Išleidimo metai: 26-Nov-2012
  • Leidėjas: CRC Press Inc
  • ISBN-10: 1466504765
  • ISBN-13: 9781466504769
Kitos knygos pagal šią temą:
Through healthcare reform, payment modifications, transparency, and a renewed focus on value, the healthcare industry is changing its organizational structure from one of a multitude of individual entities to one of a system-of-care model. This restructuring and subsequent alignment of information presents new risks and opportunities for physicians, hospitals, and other healthcare providers.

Emphasizing effective interactions between physicians and the health system, Physician Alignment: Constructing Viable Roadmaps for the Future examines the different ways physicians and hospitals can create systems to not only survive, but thrive through the changes facing healthcare. It draws on experienced authors in the area of physician purchasing to explain the various integrative models for physicians and hospitals.





Provides an accessible introduction to the different types of healthcare delivery models Covers the various types of integrationstarting with the simplest and evolving into full employment models with full integration Includes helpful information for doctors considering a transition to physician employment Highlights emerging trends in healthcare

Explaining how these systems should be constructed and aligned, the book provides healthcare organizations with a roadmap for planning for the future. The book concludes with a chapter on accountable care organizations and patient-centered medical homes that moves from the conceptual to administrative embodiments of the principles of an integrated health system as we now know it.

Recenzijos

As one who participates in medical school and health system administration, I recommend this volume for its emphasis on understanding and creating the health system of the future.David Stern, MD, Executive Dean, Vice Chancellor of Clinical Affairs, UT College of Medicine

Foreword ix
Preface xi
Acknowledgments xiii
About the Authors xv
1 Introduction: How We Got Here
1(12)
Historical Perspective
2(5)
Economic Imperatives
7(4)
Bibliography
11(2)
2 Overview of the Future
13(8)
Introduction
13(4)
Physician and Hospital Trust
17(2)
Bibliography
19(2)
3 Traditional Integration Models
21(8)
Medical Staff
21(2)
Medical Directorships
23(2)
Call Coverage
25(2)
Bibliography
27(2)
4 Revenue of the Acronyms: Co-management, IPA, and PHO Integration Structure
29(12)
Introduction
29(1)
Clinical Co-management: Share the Gain
29(5)
Co-management Example
33(1)
The Independent Practitioners Association: How Exclusive Is the Club?
34(1)
The Physician Hospital Organization: Venus and Mars Form a Company
35(3)
Bibliography
38(3)
5 Physician Employment
41(26)
What Is Old Is New: Employment
41(5)
Employment Considerations
46(2)
Changing World: Making the Decision
48(1)
Physician Employment Agreements
48(8)
From the Physician Side
48(2)
From the Hospital Side
50(1)
Physician View
51(5)
It Is All About Integration
56(1)
Foundation Model
56(1)
Physician Service Agreements
56(1)
Clinical Institutes
57(1)
Governance
57(2)
Physician Payment Models
59(3)
Appendix: Cultural Assessment Tool
62(2)
Bibliography
64(3)
6 Clinical Integration
67(12)
What Is Clinical Integration?
69(2)
Bundled Payments
71(2)
Legal Limitations to Integration
73(2)
Information Technology
75(2)
Bibliography
77(2)
7 Accountable Care Organizations and the Patient-Centered Medical Home
79(18)
Introduction
79(1)
Accountable Care Organizations
80(6)
Patient-Centered Medical Home
86(7)
How Doctors Want to Be Paid for Providing a Medical Home
92(1)
Bibliography
93(4)
8 Assessing Your Current Alignment Strategy
97(8)
9 Examples of Systems Strategic Alignment Initiatives
105(14)
Methodist Le Bonheur Healthcare
105(1)
William Breen, Jr.
Geisinger Health System
106(3)
William Breen, Jr.
Piedmont Healthcare's Integration Strategy
109(1)
James Sams
Norton Healthcare System
110(2)
Ginger Figg
Summa Health System
112(3)
Nancy A. Myers
Hospital Physician Integration: Baylor Health Care System
David J. Ballard and Paul B. Convery
115(2)
Bibliography
117(2)
10 Putting It All Together: Full Integration
119(14)
Introduction
119(1)
Blurring of Boundaries
120(1)
Health versus Healthcare
120(1)
Performance-Based System
121(1)
Demographic and Environmental Factors
122(1)
Legal Environment
123(1)
Metrics and Transparency
123(1)
Population Health
124(1)
Physician Leadership
125(1)
Patient Engagement
126(1)
Transformation
127(2)
Bibliography
129(4)
Index 133
George Mayzell, MD, MBA, FACP, FACHE, is a board-certified internist and geriatrician with over 10 years of patient care experience and over 19 years of administrative health industry experience. Dr. Mayzell assumed the role of chief executive officer of Health Choice, LLC, in November 2010. Health Choice is one of the mid-Souths leading physician hospital organizations, serving the needs of more than 518,000 health plan members through contracts with over 100 employers, insurance companies, and third-party administrators and 1500 physicians through Metro Care Physicians. One of his recent projects is to create an accountable care partnership and an innovative system of patient-focused care.

Previously, Dr. Mayzell was senior vice president and chief patient care officer at Methodist Le Bonheur Healthcare. Methodist is a seven-hospital system with over 1600 licensed beds in Memphis, Tennessee. He was responsible for patient care operations and oversight of regulatory readiness for the system. He also served as chief medical officer (CMO) for Methodist Germantown Hospital. In addition to being a past faculty member at the University of Florida, Dr. Mayzell worked at Blue Cross Blue Shield of Florida, where he was directly involved with medical management activities, including disease management, utilization review, appeals and grievances, case management, pharmacy benefits, pay for performance, and Medicare risk. Dr. Mayzell received his medical degree from New Jersey Medical and his MBA from Jacksonville University. He is the author of Leveraging Lean in Healthcare (CRC Press, 2011).

William R. (Bill) Breen Jr. has over 25 years experience in healthcare network leadership and relationship management. Bill worked at a large insurer from 1984 to 1991, building networks of physicians and hospitals to support managed care contracting. In 1991, he joined Methodist Healthcare in Memphis, Tennessee, to help lead a growing managed care network (Health Choice) that Methodist had built several years earlier. Bill rose to be the chief executive officer (CEO) of Health Choice in 1997 and assisted it through a reorganization as a full hospital/physician joint venture. During his tenure, the network grew to be the commercial market share leader in Memphis and developed numerous payer partnerships that benefitted the hospital system and over 1200 physicians. He also led the development of services to aligned physicians that improved physician practice operations and loyalty to the health system. Bill now serves as the senior vice president of physician alignment for Methodist Le Bonheur Healthcare and is responsible for implementing and managing physician alignment activities for the system and remains as a board member of the physician-hospital organization (PHO). Bill has a bachelors degree from the University of Louisville and a masters in business administration from the University of Memphis. He has achieved his fellowship in the American College of Healthcare Executives (ACHE) and is a certified medical practice executive in the Medical Group Management Association (MGMA).