Anatomy of an Acquisition Alternative: Leasing the Practice.

The default position of many healthcare systems seeking physician alignment is to acquire the practice and employ the physicians, but there is another approach that poses far less firancial risk to both parties and is far easier to undo if necessary: leasing the practice. The group stays as it is, but renders services for which the hospital receives the reimbursement and commits to paying the group a fixed amount for a stable quantum of work. Additional alignment features can be added, including medical directorships, comanagement, quality bonuses, and more. Potential problem areas include post-termination restrictive covenants and dispute resolution. Planning in advance for both fair market value disputes and addition of new practitioners is useful.

Using patient safety organizations to further clinical integration.

This article addresses why in the current context of driving toward improved value, physician groups ought to consider developing a patient safety evaluation system and reporting to a patient safety organization. The fundamental challenge to physicians to succeed in the future is to clinically integrate within their own practices, standardizing to the evidence base, and measuring their performance. In addition, it is increasingly clear that the physician office practice is a source of patient safety issues. The Patient Safety and Quality Improvement Act provides two powerful protections for data that will support and bolster clinical integration and patient safety. The protections and how to deploy them are presented.

Clinical integration and the CFO.

Healthcare CFOs should consider five strategies for promoting clinical integration: Seize the opportunity to work with physicians in demanding credible payment models from payers. Collaborate with physicians in redesigning compensation models and processes of care. Establish financial relationships with physicians who are not employed by the hospital or health system. Develop data-sharing relationships with referral sources. Become actively involved in creating an articulated, transparent approach to capacity control.

Avoiding quality fraud.

What constitutes "quality fraud"? Learn about the board's responsibilities and liability, as well as how to protect your organization from CMS and the DOJ.