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Physician engagement is more important than ever as healthcare shifts toward value-based purchasing models like accountable care organizations (ACOs), John Wallace, vice president and general manager of ACO services at McKesson.
Part of the challenge of adjusting to these new models is bringing independent-minded physicians into alignment with more team-based models, Wallace writes, which providers can accomplish with several strategies:
1. Figure out alignment incentives beyond financial ones: Although financial rewards are an important part of physician engagement, there are four major stumbling blocks for physicians transitioning to new models, Wallace says, citing a 2013 McKinsey study. They are: Feeling overwhelmed or ill-equipped; hospital/payer emphasis on employing physicians to secure engagement rather than “more effective holistic strategies that combine multiple alignment approaches;” overdependence on financial compensation as a mode of physician engagement; and low understanding of risk-based models combined with “their inherent risk aversion.”
2. Consider group dynamics: To engage physicians, organizations must focus on building relationships, two-way communication and decision-making that involves wide participation, according to Wallace. “ACO leaders should either emphasize or downplay a physician practice’s relationship to the whole, depending on the level of independence the group perceives for itself,” he writes.
3. Keep physicians in the loop: Wallace cites the McKinsey study’s finding that people are more likely to change their behavior if they understand the reasoning behind the changes, as well as if they have role models for them. Moreover, providers must make sure physicians have the skills and knowledge necessary to accomplish the required changes, and have environmental support for those alterations, including compensation, training and information systems.
A June survey found many doctors think their systems lack physician engagement. The survey concluded that to improve engagement, organizations could take steps such as asking doctors specific questions about how engaged they feel, creating clear plans for what needs to change and sharing survey results.