Advanced Practice Provider Leadership Structures

The Evolution of a Well-Defined Advanced Practive Provider Leadership Structure

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Featured in AAPL's Physician Leadership Journal

Advanced practice provider leadership is critical to the optimization of the growing APP workforce.

COVID-19 has accelerated the financial and operational challenges facing the health care industry and organizations are reevaluating current processes and structures. As a result of this pandemic, some health systems and medical groups are planning for an increasingly uncertain future. These changes have also presented the opportunity to design more effective care delivery models, right-size cost structures, and streamline organizational processes to enhance financial sustainability going forward.

Prior to the pandemic, many hospitals and health systems had begun to prioritize the integration, optimization and engagement of their advanced practice provider (APP) workforce as a strategy to enhance organizational performance and support the transition to value-based care. In response to COVID-19, many organizations are utilizing their APPs to support operations. This has, in many cases, helped to accelerate the optimization of these clinicians.

As one of the fastest-growing workforces in health care, APPs constitute, on average, more than one-third of an organization’s clinical workforce. APP leaders are critical to the organization and optimization of this workforce. The presence of a well-defined advanced practice provider leadership structure can drive organizational performance and support a comprehensive APP workforce strategy – which can help to improve access, increase revenue and reduce costs. Understanding the evolution of APP leadership positions at the top, clinical, managerial and functional levels, along with their different roles and responsibilities, can serve as a roadmap for organizations as they continue to build out and develop their own APP structures and programs.


PRESS RELEASE | Sophisticated Compensation Enhancements Added PPMT™

SullivanCotter's comprehensive physician compensation software now includes innovative automation enhancements for its new Clinician Pay feature

June 15, 2021 – Chicago – SullivanCotter, the nation’s leading independent consulting firm in the assessment and development of total rewards programs, workforce solutions, and technology and data products for the health care industry and not-for-profit sector, announces the addition of highly-anticipated new compensation automation enhancements to its growing physician compensation software solution – Provider Performance Management TechnologyTM (PPMT).

With the new Clinician Pay feature, PPMT™ now enables users to streamline the compensation management process by automating clinical draw calculations and payments based on current performance and organization-defined criteria. It offers flexible and sophisticated rules for the draw calculations that are easily maintained by key administrative stakeholders and can be managed throughout the year.

“Determining clinician draw for the upcoming year is a significant and burdensome time investment for compensation program administrators. Most often, these calculations are done manually via spreadsheets – which can greatly increase the risk of error. Using PPMT™, organizations can now automate the production of accurate and reliable draw and other pay calculations within one system”, said Shelly Slowiak, Director, Product Support, PPMT™, SullivanCotter.

New split role compensation automation eliminates the need to manually determine clinical and non-clinical pay components by providing visibility into performance and compensation for different roles while also allowing administrators to view aggregate compensation for each individual clinician.

“In order to provide the best care for patients, a growing number of physicians are specializing in multiple service areas with varying compensation arrangements. This often requires greater attention and additional analysis from an already overextended compensation team. PPMT™ can ease the administrative burden by effectively automating and providing consistent compensation calculations for each service area”, said David Schwietz, Chief Information Officer, SullivanCotter.

Designed to address a spectrum of physician, leadership and other key stakeholder needs, PPMT™ combines years of health care compensation insight and expertise with an intuitive and automated technology platform to help drive provider performance and support the transition from volume- to value-based care.

For more information on these enhancements or our entire suite of Provider Performance Management Technology™, visit www.sullivancotter.com/PPMT or contact us at 888.739.7039.

 About SullivanCotter

SullivanCotter partners with health care and other not-for-profit organizations to understand what drives performance and improve outcomes through the development and implementation of integrated workforce strategies. Using our time-tested methodologies and industry-leading research and information, we provide data-driven insights, expertise, data and technology to help organizations align business strategy and performance objectives – enabling our clients to deliver on their mission, vision and values.


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PRESS RELEASE | Benchmarks360™ - APP Utilization and Perceptions Manager

SullivanCotter Releases Comprehensive APP Utilization and Perceptions Manager for its Growing Benchmarks360™ Platform

April 21, 2021 – Chicago – SullivanCotter, the nation’s leading independent consulting firm in the assessment and development of total rewards programs, workforce solutions, and technology and data products for the health care industry and not-for-profit sector, is pleased to announce the addition of powerful new capabilities for assessing advanced practice provider (APP) utilization and workforce perceptions to its growing Benchmarks360™ platform.

Powered by SullivanCotter’s proprietary surveys and research, Benchmarks360™ is a suite of intelligent, web-based products that enables health care organizations to analyze and visualize compensation, clinical productivity and workforce perceptions through industry-leading data, analyses and reporting.

"In today's unprecedented health care environment, it is important for organizations to utilize, engage and retain their clinical workforce more effectively. APP turnover can significantly impact cost, morale and operations, and gaining access to the right data and benchmarking tools can help to enhance workforce retention, team-based care practices and organizational performance during such a critical time,” said Amy Noecker, APP Workforce Practice Leader, SullivanCotter.

SullivanCotter’s Benchmarks360™ APP Utilization and Perceptions Manager allows organizations to collect, benchmark and report on the thoughts and experiences of their APPs and physicians related to APP compensation, resources and job responsibilities to help ensure current pay programs and care models are competitive and effective. In addition to data on nurse practitioners and physician assistants, it also provides information and analysis on other members of the APP workforce including certified registered nurse anesthetists and certified nurse midwives.

This new module includes two surveys designed to measure and compare individual organizations to national benchmarks.

APP: Utilization and Perceptions Survey

Learn more about the APP employment experience within your organization regarding scope of practice, clinical and non-clinical responsibilities, and perceptions on culture and compensation. Specific insights include:

  • Organizational structure, support and processes related to the APP workforce
  • Roles on the care team specific to location and specialty
  • Degree of integration and care team support
  • Opportunities for improved utilization and engagement

Physician: APP Utilization and Perceptions Survey

Learn more about your physician workforce and their experience working with APPs. Specific insights include:

  • Perception on APP integration and utilization
  • Roles of APPs on the care team
  • APP impact on quality, access and patient engagement
  • Understanding of regulatory requirements
  • Opportunities for improved alignment and team performance

These surveys may serve as a resource for organizations looking to better understand the current state of their APP workforce – including quantifying opportunities for optimization and readiness for change – and can play an important part in a more holistic review of APP practices when combined with SullivanCotter’s comprehensive advisory services.

“As health care organizations continue to navigate the lasting effects of a global pandemic, SullivanCotter remains committed to providing them with the critical, data-driven insights they need to measure, analyze and report on compensation and workforce performance. With the goal of addressing the increasingly complex and evolving needs of our clients, we are developing one of the industry’s most comprehensive benchmarking solutions by continuously refining our product roadmap and adding innovative new resources and functionality,” said David Schwietz, Chief Information Officer, SullivanCotter.

To learn more about Benchmarks360™, including important licensing information and a full list of features and functionality, visit sullivancotter.com/benchmarks360 or call 888.739.7039.

About SullivanCotter

SullivanCotter partners with health care and other not-for-profit organizations to understand what drives performance and improve outcomes through the development and implementation of integrated workforce strategies. Using our time-tested methodologies and industry-leading research and information, we provide data-driven insights, expertise, data and technology products to help organizations align business strategy and performance objectives – enabling our clients to deliver on their mission, vision and values.


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Population Health

Case Study | Union Health – Population Health Management

Improving Patient Care and Optimizing Financial Performance

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As health care continues to shift from productivity and fee-for-service models to more of a quality and performance-based approach, value-based care (VBC) strategies, including population health management (PHM) programs, are becoming a top priority for health care systems across the nation. Leaders within these organizations are searching for more effective and sustainable solutions as they navigate declining reimbursement, regulatory changes, physician burnout and the need for better patient care and lower costs.

These challenges can be addressed with a tailored PHM strategy that supports organizational improvement in the following key areas:

  • Maximizing operational processes and outcomes
  • Developing a support network for physicians and advanced practice providers (APPs)
  • Mitigating risk
  • Enhancing performance in a value-based environment

By identifying actionable and targeted opportunities for improvement through a series of evaluations and readiness assessments, Union Health, an integrated, not-for-profit health system based in western Indiana, was able to develop comprehensive VBC and PHM strategies better aligned with their patient-focused approach to coordinated care.

The Situation

As a six-year participant in a local, tertiary accountable care organization (ACO), Union Health had fully outsourced its operational leadership to the parent ACO member. This legacy partnership and arrangement was simply not producing the desired results from a clinical, operational or financial perspective for Union Health – with data and analytics, physician engagement, embedded care management and post-acute care spend being specific areas of concern. Around 2018, Union Health was at a strategic crossroads in regard to its investment in VBC initiatives as the PHM program was not generating the desired results.

This highlighted the need to more effectively integrate operations across departments and service lines, align incentives for leadership and physicians, and reallocate related resources. At the same time, many competing health systems in Indiana were already realizing the benefits of a highly functional PHM program. The leadership at Union Health recognized the key to success would be through a more consistent approach, improved internal processes and engaged leadership.

The organization decided to narrow its focus by strengthening internal capabilities around care management, physician engagement, analytics and reporting to help ensure greater levels of risk-based contracting success with the Centers for Medicare and Medicaid Services (CMS) and other commercial payors.

The Approach

In late 2018, Union Health was presented with an opportunity to partner and align with a nationally recognized health system in a more advanced Next Generation ACO. A Next Generation ACO model offers more risk and reward (both upside and downside risk scenarios) for health systems who already have highly functional internal capabilities in place to support performance. These models represent some of the most advanced value-based arrangements and require greater system-wide operational sophistication. Union Health was looking for a hands-on approach to align initiatives and ensure success.

In order to assess internal operational capabilities, physician and advanced practice provider engagement levels, incentive models and other key functional areas related to VBC, senior leadership at Union Health collaborated closely with SullivanCotter to help quantify this opportunity. After conducting a comprehensive VBC readiness assessment, which included a close examination of the program’s core functional areas such as partnerships, utilization management, attribution and chronic disease management, Union Health elected to partner with the larger health system who had already demonstrated greater success in the Next Generation ACO model. Moreover, Union Health committed to this arrangement for a minimum of two years to support the development of a strong VBC program. Health systems across the country often partner and align with other systems or independent groups to help mitigate risk and better manage overall cost.

SullivanCotter’s primary role with Union Health was to develop and implement an independent PHM program that would help to improve risk-based contracting performance. The program focused on five core principle areas:

  • Annual care
  • Risk acuity
  • Utilization management
  • Care management
  • Incentive alignment

With these principles in mind and a significant amount of physician and APP input and collaboration, the design of the system’s VBC strategy and approach included the following phases:

 

 

 

 

 

 

 

To help implement the multi-phased strategy, a task force consisting of Union Health’s executive team and leaders in Business Development, Population Health Management, Physician Services, Utilization Management and Care Management was created to help oversee the process. The initial phase of the project consisted of in-depth interviews with physicians and stakeholders, a thorough review of data and performance metrics, and an operational Readiness Assessment. Key findings from this phase revealed:

  • Low engagement from physicians, APPs and other staff with annual care and preventative medicine strategies
  • Significant lack of Care Management resources and coordination such as outpatient pharmacy support, discharge planning and risk stratification
  • Limited definition of roles and responsibilities for Care Management and Operations team members specific to VBC and PHM
  • Insufficient value-based data resources such as reporting capabilities, quality dashboards and clarity surrounding key performance indicators
  • Lack of clarity in the scope of practice for nurse practitioners and physician assistants in current team-based care model
  • Physician and APP compensation and incentives were not aligned with VBC strategies and initiatives; no incentive for physicians and APPs to enhance value-based performance
  • The CMS benchmark or threshold was not met in the contract in order to achieve shared savings – resulting in negative financial impact and poor contract performance

Using the findings from this readiness assessment, SullivanCotter helped executives and physicians at Union Health to further develop a roadmap for the Program Development and Implementation phase.

Roadmap initiatives included the development of:

  • Physician and APP educational and engagement materials for workshop sessions
  • Clearly defined roles and scope of practice for nurse practitioners and physician assistants in primary care
  • Outpatient-focused clinical capacity analysis to support Care Management
  • Comprehensive annual care strategy focused on prevention and wellness
  • VBC Management team to monitor performance and contract relationships
  • Physician and APP incentive components to enhance VBC and PHM
  • Standardized dashboards for the entire care team
  • Post-acute care strategies more closely aligned with Care Management
  • Strategies to monitor ongoing performance

Once the initial components of the roadmap were deployed, the task force worked with SullivanCotter to begin the planning process for two remaining phases within in the PHM model: Physician and APP Incentive Alignment and Performance Review and Monitoring. These processes were also implemented and rolled out during PHM program development and focused on monitoring and enhancing performance in all value-based contracts.

The work accomplished in these two phases included:

  • Population health metrics related to annual care, preventative screenings, vaccinations, utilization management, Care Management team engagement and risk-adjustment
  • Value-based compensation design concepts and continued education provided to physicians and APPs
  • Regular monthly huddles with Care Management team members to review patient volume
  • A risk stratification process to determine appropriate care levels for patients
  • Physician and APP interviews for feedback and evaluation
  • Physician and APP engagement scoring and methodology
  • Refinement of key performance indicators
  • Development and rollout of physician and APP performance dashboard

The Results

Through the investment in and development of the PHM program and other related VBC initiatives, Union Health was able to achieve the following results over a 12-month period:

  • Achieved significant shared savings in year one of the Next Generation ACO as compared to historical performance with improvement of over $6M
  • Reduced per member per month spend compared to prior year by 12%
  • Implemented a newly redesigned approach to primary care by focusing on team-based care delivery
  • Increased the number of completed and billed Medicare Annual Wellness Visits (AWV) from 900 to 5900 with AWV revenue up from approximately $150,000 to $944,000
  • Raised the number of documented Care Management team episodes by more than 200%
  • Lowered number of emergency room visits in the Next Generation ACO population that were deemed “PCP treatable”
  • Documented more than 100 Care Management success stories
  • Boosted the clinical diagnosis documentation rate by more than 20%
  • Enhanced coordination with post-acute care partners and facilities to help reduce total cost of care for ACO patients by 11%
  • Conducted regular meetings and monthly Care Management huddles to enhance physician and APP engagement with knowledge of VBC and PHM concepts and monitoring of individual performance
  • Initiated strategic planning to redesign primary care and other specialty compensation models with a focus on performance and value

Tips for Successful VBC/PHM Program Implementation

  • Assign dedicated resources to care team optimization
  • Collaborate with and gather input from physicians and APPs to strengthen engagement and buy-in
  • Align physician and APP incentives to help streamline and reward clinical efforts
  • Establish achievable milestones to maintain momentum and engagement
  • Conduct regular key stakeholder meetings to provide updates on progress, celebrate successes and course-correct as needed

Lessons Learned

Despite the many factors that differentiate health systems, such as organizational size, complexity, or the communities they serve, there are a common set of fundamental guiding principles and success factors that can be tailored to each organizations’ VBC and PHM strategies.

Union Health’s multi-phase approach – including Readiness Assessment, Program Development and Implementation, Physician and APP Incentive Alignment, and Performance Review and Monitoring – has proven to be an effective way of improving overall performance through the creation of comprehensive VBC and PHM strategies.

Dedicated to enhancing internal capabilities, resources and value-based performance with the objective of improving population health, Union Health partnered with SullivanCotter to develop a long-term, sustainable strategy and implement a comprehensive program to help to improve access and health outcomes for its patients, strengthen physician and APP engagement, and significantly boost financial performance.


Leveraging data-driven insights and over 25 years of experience, SullivanCotter partners with organizations to develop comprehensive value-based care and population health management strategies tailored to the unique needs of each client.

Contact us for more information.


INFOGRAPHIC | Certified Registered Nurse Anesthetists: Compensation and Pay Practices

Detailed insight into CRNA compensation, pay practices, work effort and more

In addition to providing critical base salary and total cash compensation benchmarking information for this important subset of the APP workforce, SullivanCotter’s Advanced Practice Provider Compensation and Productivity Survey has now expanded to include detailed insight into CRNA-specific pay practices as well.

While CRNAs are vital members of this growing workforce, the unique nature of their roles includes key differences in work effort and premium pay practices when compared to other APPs.

View highlights from the 2020 survey results to learn more!

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ON-DEMAND WEBINAR | Optimize Clinical Resources to Support Population Health Management

Understanding the Strategic Impact of a Physician Needs Assessment

Wednesday, May 19 | 12:30-1:30PM CT

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Hosted by the American Hospital Association/Health Forum

Access to market-specific physician supply and demand data is critical as hospitals and health systems look to support growth, enhance value-based care delivery, and reassess cost and efficiency concerns.

Health care organizations must identify the right amount and type of physician specialties to operate effectively in the markets they serve with the goals of optimizing clinical performance as the focus on value-based care and population health management intensifies.

Learn how accurate and actionable data-driven insight can help hospitals and health systems to identify, monitor and respond to changing service needs and physician and advanced practice provider (APP) staffing requirements. Decide strategically whether to recruit, employ or affiliate to create a competitive edge in today’s rapidly evolving health care environment.

During this webinar, industry experts from SullivanCotter will discuss:

  • Partnering with Union Health on strategies to support expanded value-based care and population health management requirements
  • Evaluating the market-specific drivers that influence physician demand
  • Accurately pinpointing employed and affiliated market physicians by specialty
  • Leading practices and innovative approaches to inform physician strategy and alignment efforts to enhance performance
  • Creating a competitive edge by optimizing clinical resources

Case Study | The Key Role of Advanced Practice Providers in Today's New Normal

Featuring Stanford Health Care's Strategy to Heighten APP Integration and Engagement

As health care organizations nationwide continue to balance managing the immediate implications of the COVID-19 pandemic with planning for what lies ahead, many are looking to optimize team-based care delivery to help address emerging operational challenges, maintain financial sustainability, and meet evolving patient needs.

With the ability to direct patient care and generate revenue, advanced practice providers (APPs) are critical members of the care team and can play an important role in this transformation.

Featuring a case study published in AAPL's Physician Leadership Journal, learn more about how SullivanCotter partnered with Stanford Health Care to develop a comprehensive strategy and program to maximize utilization, support optimization and enhance engagement for its growing APP workforce.

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HFMA | Navigating Change: Implications of CMS's 2021 Physician Fee Schedule

Addressing the impact on physician compensation and productivity

Featured in HFMA's hfm Magazine, SullivanCotter discusses changes to the 2021 Physician Fee Schedule and highlights challenges health care organizations and their financial leaders are facing as they look to address the impact on physician and advanced practice provider compensation and productivity.

Due to the magnitude of the changes within the final rule for the 2021 Physician Fee Schedule, organizations with productivity-based physician compensation plans must understand the implications of these changes and on payer payments, productivity levels, survey benchmarks and regulatory compliance.

Learn more about the short- and long-term impact of the changes and different approaches to consider as you move forward with 2021 compensation decisions.

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INFOGRAPHIC | 2020 Advanced Practice Provider Compensation and Pay Practices Survey

Representing nearly 20% of all practicing APPs nationwide

Advanced practice provider (APP) compensation programs are shifting to address changing market dynamics and mitigate the financial implications of COVID-19. Considering the current impact of the pandemic, the 2020 survey represents the best data reference point for use in the near future and can serve as a foundation for understanding specialty market positioning leading into COVID-19, pinpointing areas of focus for targeted compensation adjustments, and assisting with post-pandemic budget and productivity planning.

SullivanCotter’s 2020 APP Compensation and Pay Practices Survey contains data from nearly 700 organizations on over 84,500 individual APPs and represents nearly 20% of all practicing APPs nationwide. New in 2020, the survey now also reports expanded work effort data for specialty-based APPs, CRNA-specific pay practices and additional productivity data.

The 2021 survey is now open for participation. Don't miss your chance to submit data and gain access to exclusive APP compensation, pay practices and productivity data!

View highlights from the 2020 results to learn more - including base salary and total cash compensation, incentive compensation, premium pay and clinical productivity.

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INFOGRAPHIC | Benchmarking Resources for the Medical Group Workforce

Gain access to critical medical group benchmarking data for the entire health care workforce - including executives, physicians, advanced practice providers and other health care staff

This year more than ever, medical groups require access to critical data-driven insights as they look to address the impact of COVID-19 on workforce compensation and productivity, prepare for the 2021 Physician Fee Schedule changes, and balance the need for competitive total reward programs against pressure on operating margins.

Learn more about SullivanCotter’s growing suite of medical group benchmarking resources for all your workforce needs – including annual compensation data and incentive award opportunities for executives, detailed productivity reporting for physicians and advanced practice providers, and market data by organization size, region, state and more for other health care staff positions.

Our suite of 2021 health care compensation surveys are now open for participation! 

View highlights from the 2020 results to learn more about SullivanCotter's proprietary benchmarking data and resources available to medical groups.

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ARTICLE | 10 Best Practices for the Board's Human Capital Committee

Featured in McDermott Will & Emery's new e-book from its Governing Health series

SullivanCotter's Kathy Hastings, Executive Workforce Practice Leader, and Tim Cotter, Manging Director, have contributed to a new e-book from McDermott Will & Emery entitled Key Agenda Items for Board Committees: A Briefing for Governance and Executive Leadership.

Their chapter focuses on the board human capital committee and the key role it plays in guiding human resources strategies as health care organizations face today's challenges. Human capital is critical to organizational strategy, and the committee should test whether the components of the human capital strategy – namely people, process and technology practices – can sustain the organization.

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PRESS RELEASE | SullivanCotter Integrates Health Care Contract Management Solution into PPMT™

Partnering with Ntracts to deliver full-scale contract lifecycle management capabilities

November 30, 2020 – Chicago – SullivanCotter, the nation’s leading independent consulting firm in the assessment and development of total rewards programs, workforce solutions, and technology and data products for the health care industry and not-for-profit sector, has partnered with Ntracts, a premier health care contract management solution, to incorporate full-scale contract lifecycle management as part of its comprehensive Provider Performance Management Technology™ (PPMT) platform. PPMT™ is an industry-first, cloud-based solution that enables engagement and alignment of the clinical workforce through the automation of performance-based compensation administration, analytical and reporting capabilities. Ntracts allows organizations to mitigate contract compliance risk and streamline the contracting process across the entire enterprise.

Designed to address a spectrum of physician, leadership and other key administrative needs, PPMT™ delivers centralized and actionable data tailored to the unique needs of each stakeholder. It combines years of health care compensation insight and expertise with an intuitive, automated technology platform, and serves as a single source of truth that helps empower physicians to drive desired outcomes and enhance organizational performance.

Ensuring that physician employment agreements align with system-wide compensation terms and payments remains a challenge for health care organizations nationwide. With the addition of Ntracts, PPMT™ will include a cutting-edge contract lifecycle management component that will provide hospitals and health systems with an accurate and comprehensive view of clinical employment contracts across the organization in real-time. By effectively integrating the compensation, performance and contract lifecycle management process into one centralized platform, PPMT™ will help to drive results through greater alignment, transparency and insight.

“Health care continues to evolve at a rapid pace, and there are number of complex moving parts to navigate as it relates to physician compensation and performance. By adding critical contract management capabilities to help health care organizations reduce risk, maintain compliance with changing regulatory requirements, and improve operational efficiency, PPMT™ will be a full-scale solution designed to support the transition from volume to value-based care,” said David Schwietz, Chief Information Officer, SullivanCotter.

David Paschall, Chief Executive Officer of Ntracts, adds, “SullivanCotter shares our commitment to quality and we are proud to combine our industry-leading contract lifecycle management solution with SullivanCotter’s expertise in physician compensation and performance. Together we can offer an unmatched, end-to-end technology solution to support health care organizations as they work to drive change and deliver long-term, sustainable results in this quickly evolving environment.”

For more information on Provider Performance Management Technology™, visit www.sullivancotter.com/PPMT or contact us at 888.739.7039.

About SullivanCotter

SullivanCotter partners with health care and other not-for-profit organizations to understand what drives performance and improve outcomes through the development and implementation of integrated workforce strategies. Using our time-tested methodologies and industry-leading research and information, we provide data-driven insights, expertise, data and technology to help organizations align business strategy and performance objectives – enabling our clients to deliver on their mission, vision and values.

About Ntracts

Ntracts, Inc. offers a software-as-a-service application that enables users to originate, search for and report on contracts. The application also accelerates the contract review and approval process by automatically notifying responsible parties of contract requests, approaching expiration dates and other critical performance milestones, saving clients both time and money. Ntracts, Inc. is based in Indianapolis, Indiana, and was founded by Hall, Render, Killian, Heath & Lyman, the nation's leading health care law firm.


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PRESS RELEASE | SullivanCotter Releases Enhanced Patient Panel Management Capabilities for PPMT™

Utilize SullivanCotter's industry-first physician compensation software to automate the assignment of patients to clinician panels through sophisticated organization-defined rules

October 28, 2020 – ChicagoSullivanCotter, the nation’s leading independent consulting firm in the assessment and development of total rewards programs, workforce solutions, and technology and data products for the health care industry and not-for-profit sector, launches expanded patient panel management functionality in the latest update of its comprehensive Provider Performance Management Technology™ (PPMT). PPMT™ is an industry-first, cloud-based physician compensation software that enables provider engagement through transparent performance-based compensation administration, reporting and analytical capabilities.

As the focus on optimizing team-based care to achieve better patient outcomes intensifies, health care organizations require more effective strategies and resources for facilitating patient panel management. PPMT™ enables organizations to automate the assignment of patients to clinician panels through sophisticated client-defined rules. It then calculates a risk-adjusted panel size and applies compensation calculations for a group or individual based on an organization’s requirements – providing the flexibility to change patient attribution and/or panel compensation assignments as clinical teams evolve. PPMT™ allows for greater transparency into panel composition and serves as a single, centralized source of truth for clinician compensation.

“Properly attributing patients to the correct clinician’s panel can require hours of administrative time each month. Combined with detailed analytics and powerful auditing and adjustment tools, the new panel management functionality streamlines this process to ensure more accurate attribution and support effective panel management programs,” said Shelly Slowiak, Director, Product Support, Provider Performance Management Technology™, SullivanCotter.

Designed to address a spectrum of physician, leadership and other key stakeholder needs, PPMT™ combines years of health care compensation insight and expertise with an intuitive, automated technology platform to help drive clinician performance and support the transition from volume- to value-based care. It incorporates SullivanCotter’s industry-leading benchmarking data into three integrated modules, including Provider Performance Management, Provider Productivity Insights and Compensation Management Analytics.

“We’re working hard to understand our clients’ changing needs and priorities and, as a result, will continue to refine our product roadmap and deliver the functionality they require to help navigate such a dynamic marketplace. This innovative new functionality will serve to strengthen our existing physician compensation software and panel management capabilities, and is a welcome addition to PPMT™ as we strive to develop one of the industry’s most comprehensive, end-to-end technology products for managing clinical compensation and performance,” said David Schwietz, Chief Information Officer, SullivanCotter.

For more information on Provider Performance Management Technology™, visit www.sullivancotter.com/PPMT or contact us at 888.739.7039.

About SullivanCotter

SullivanCotter partners with health care and other not-for-profit organizations to understand what drives performance and improve outcomes through the development and implementation of integrated workforce strategies. Using our time-tested methodologies and industry-leading research and information, we provide data-driven insights, expertise, data and technology to help organizations align business strategy and performance objectives – enabling our clients to deliver on their mission, vision and values.


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INFOGRAPHIC | Considerations for Addressing the 2021 E&M Work RVU Changes

Considerations for Addressing CMS' final changes to the 2021 E&M Work RVU Values


RELATED CONTENT:
ARTICLE | 2021 Evaluation and Management CPT Codes: Understanding the Impact on Physician Compensation
ARTICLE | Navigating Change: Implications of the 2021 Physician Fee Schedule
SullivanCotter's CPT Advisory Services and Technology Solutions


Following its annual review of the American Medical Association’s Relative Value System Update Committee’s recommendations, the Centers for Medicare and Medicaid Services (CMS) finalized proposed changes to the 2021 Physician Fee Schedule and has significantly overhauled the Evaluation and Management (E&M) code documentation requirements, time-effort recognition, and wRVU values for new and established patient office visits.  These changes were effective as of January 1, 2021.

As organizations look to understand the impact of these changes on reported physician productivity levels, it is also important to assess the effect it will have on physician compensation arrangements, fair market value and commercial reasonableness considerations, financial sustainability and national survey benchmarks.

Contact us or visit our CPT Solutions page learn more about assessing the impact of the E&M code changes within your organization.

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PRESS RELEASE |
Hospital Sisters Health System Implements PPMT™

Hospital Sisters Health System Selects Innovative Technology Product to Automate and Enhance Physician Compensation and Performance Management Capabilities

October 13, 2020 – Chicago – SullivanCotter, the nation’s leading independent consulting firm in the assessment and development of rewards programs and workforce solutions for the health care industry and not-for-profit sector, has partnered with HSHS Medical Group and Prairie Cardiovascular, two Hospital Sisters Health System ministries, to implement its comprehensive Provider Performance Management Technology™ (PPMT).

Hospital Sisters Health System is a large, multi-institutional health system committed to delivering high-quality, patient-centered care to communities throughout Illinois and Wisconsin. By leveraging PPMT™, an industry-first, cloud-based product that enables physician and APP engagement through transparent performance-based compensation administration and analytical capabilities, the organization is looking to automate and align the management of clinician pay and performance across its medical group.

Driven by the need to provide a growing network of physicians with more accurate compensation and productivity data, HSHS Medical Group and Prairie Cardiovascular started the journey with an in-house application designed to enhance a process that was once very manual. Developing the right mix of internal resources and support to expand the application’s capabilities in line with the system’s evolving needs, however, proved difficult.

“We required a more comprehensive system with the ability to flex and scale with us as we add or change value-based incentives, modify compensation plans and analyze the impact of Evaluation and Management CPT code changes. PPMT™ will now enable us to automatically deliver extensive supporting documentation with drill-down capabilities to the patient-level for our clinicians to access any time they want. Providing this visibility and transparency is critical as we navigate an increasingly complex and rapidly changing health care environment,” said Linda Dace, System Vice President of Finance, Hospital Sisters Health System.

PPMT™ incorporates SullivanCotter’s industry-leading benchmarking data into three integrated modules, including Provider Performance Management, Provider Productivity Insights and Compensation Management Analytics. Hospital Sisters Health System selected all three modules to help support their goals - allowing for a more cohesive approach to compensation and performance management.

For more information on Provider Performance Management Technology™, visit www.sullivancotter.com/PPMT or contact us at 888.739.7039.

About SullivanCotter

SullivanCotter partners with health care and other not-for-profit organizations to understand what drives performance and improve outcomes through the development and implementation of integrated workforce strategies. Using our time-tested methodologies and industry-leading research and information, we provide data-driven insights and expertise to help organizations align business strategy and performance objectives – enabling our clients to deliver on their mission, vision and values.


 

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Optimizing Care Delivery in Response to COVID-19

Supporting system-wide alignment in an evolving health care environment

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Health systems nationwide continue to face a number of unprecedented challenges due to the evolving COVID-19 pandemic. Supporting financial sustainability remains a top priority. As the industry looks ahead and makes plans for financial recovery and operational transformation, optimizing care delivery to improve efficiency, drive workforce performance and increase revenue is a critical step in this process.

Care delivery optimization between systems and their affiliated hospitals, integrated practices, and physician and advanced practice provider (APP) workforces can promote financial sustainability by identifying gaps in care delivery, improving operational efficiency, reducing clinical variation, and expanding capacity for important growth initiatives. To help accomplish this, there are five key areas that health care organizations should focus on as they look to position themselves to deliver the greatest possible value.

SullivanCotter recommends a thoughtful and strategic review of the following areas:

Physician/APP-Hospital Alignment

Aligning operations, goals and results across the organization is key to building a workforce that is unified and supports organizational strategy. To enhance care delivery optimization, organizations should:

  • Assess current physician affiliation relationships, including pending and/or potential mergers and acquisitions and consider:
    • Updating due diligence assessments in the context of COVID-19 to include financial analysis and review of agreements
    • Reviewing key characteristics of existing compensation arrangements and performance requirements to conduct best practice comparisons by affiliation model/relationship and assure incentives are aligned between the models
  • Evaluate current and projected physician and APP staffing requirements and care team development to address community need, integrated practice and service line needs
  • Review current and potential Service Line Co-Management or HEIP (Hospital Efficiency Improvement Plan) arrangements to ensure the metrics are still aligned with system goals
  • Assess physician involvement in the decision-making process, including medical group and service line governance structure
  • Consider clinical workforce culture and perceptions related to strategic objectives while also identifying opportunities for improvement

Medical Group Operational and Financial Performance

Evaluating a medical group’s overall performance against a variety of operational and financial metrics will help identify actionable areas for improvement.

  • Assess key medical group and/or specialty-level operational and financial performance indicators
    • Review and update productivity thresholds and benchmarks, revenue, expenses and overall financial performance, staffing ratios, measured outcomes, patient capacity and clinic throughput
    • Evaluate performance indicators shared with physicians and APPs and ensure systems are in place to provide transparent and timely information on performance relative to benchmarks, service line and system strategic goals
    • Consider primary care model redesign and develop financial feasibility pro forma based on volume expectations and clinical regulations
    • Focus on care delivery models designed to achieve optimal financial performance with a patient-centric focus (e.g., improves satisfaction, APPs practice at top-of-license, yields appropriate return on investment)
  • Perform workflow assessment at the service line and practice levels to evaluate patient access and throughput, including the utilization of telehealth and remote services

Specialty and Service Line Care Delivery

Once the medical group’s overall performance has been assessed and specific underperforming specialties have been identified, it is important to do a deep dive into specialty and service line performance. Assessing clinical workforce performance is imperative as organizations look to increase the focus on value-based outcomes associated with quality and cost.

  • Evaluate unwarranted care variation and cost-efficiency opportunities
  • Develop strategies to reduce length of stay variance, readmission and value-based care penalties
  • Perform service line and facility-based workforce planning and staffing efficiency assessments
  • Identify appropriate benchmarks related to cost of care against internal and external cohorts
  • Review physician referral processes to help project actual and expected volumes

Readiness for Value-Based Care

Successfully navigating the transition from volume to value relies largely on enhancing patient access. Care model designs that do not support this goal will likely result in stagnant market share or loss of patients.

  • Conduct a physician needs assessment, demographic map and strategic plan to match service needs within market segments based on expected changes
  • Perform analysis of telehealth capacity, financial return on investment and regulatory requirements
  • Assess clinic space, including waiting room access and throughput in light of COVID restrictions

APP Utilization

APPs are one of the fastest growing segments of the health care workforce. Integrating APPs as key members of the care delivery team and utilizing them to their full potential can help an organization to achieve a number of important goals – including improved patient access, increased revenue, and enhanced quality and service while also reducing the cost of care.

  • Perform a current-state analysis by comparing APP utilization and productivity to market benchmarks based on specialty and role:
    • Quantify the financial opportunity available with a fully optimized APP workforce
    • Conduct a readiness assessment to determine barriers and cultural considerations related to full APP optimization
    • Identify specific specialties or service lines with the most opportunity (financial or non-financial) and readiness for change
  • Review and update APP organizational practices:
    • Assess governance structures, recruitment and retention policies, and training and development programs
    • Align organizational bylaws, policies, practices and operations to federal and state laws, payer policies and procedures, and leading market practices

Conclusion

The process of evaluating these five focus areas will help to highlight and quantify opportunities for improving patient access, enhancing organizational efficiency, increasing revenue and reducing costs as health systems plan for what lies ahead. For each area of focus, SullivanCotter recommends developing an in-depth assessment, utilizing operational and financial expertise and incorporating comparative benchmark data analysis to define potential solutions unique to the requirements of each system to help optimize clinical performance and achieve key organizational goals.

 

Leveraging data-driven insights and over 25 years of experience, SullivanCotter partners with organizations to develop comprehensive care delivery optimization strategies tailored to the unique needs of each client.


PRESS RELEASE | SullivanCotter Launches New Physician Needs Assessment

SullivanCotter Launches New Physician Needs Assessment Application to Support Critical Staffing and Service Line Requirements

September 15, 2020 – Chicago – SullivanCotter, the nation’s leading independent consulting firm in the assessment and development of rewards programs and workforce solutions for the health care industry and not-for-profit sector, announces the launch of its new Physician Needs Assessment (PNA). SullivanCotter’s PNA is an interactive, cloud-based application that delivers actionable, data-driven insight into physician supply and demand to help organizations identify, monitor and respond to changing service line needs and physician workforce staffing requirements.

By leveraging real-time market intelligence, custom analyses and tailored forecasting scenarios, this innovative new PNA application enables organizations to dynamically address emerging market trends, changing population demographics and evolving physician practice patterns.

Using proprietary benchmark data from over 1,500 organizations and 400,000 physicians, SullivanCotter’s advanced methodology analyzes more than 1 billion unique claims annually to accurately calculate the physician surplus or deficit within a specific area by determining supply, forecasting wRVU utilization and adjusting to various market-specific demographics – including geography, economic factors, age/gender, payment types and managed care –  to calculate subsequent demand projections.

“In today’s increasingly uncertain marketplace, health care organizations remain acutely focused on recovery and what lies ahead in a post-COVID-19 operating environment. As hospitals and health systems look for better ways to support financial sustainability, assess clinical optimization opportunities, drive performance, and manage physician resources and service line needs, organizations must determine the right amount and type of physician specialties to operate effectively in the markets they serve ,” said Ted Chien, President and Chief Executive Officer, SullivanCotter.

Additional features and functionality include:

  • A rigorously researched, call-verified and editable physician and APP supply roster based on multiple data sources that includes tracking of employment and affiliations
  • Interactive mapping tool with the ability to select specific zip codes for strategic consideration and to account for any shifts in demographic mix
  • Predictive modeling to assess the impact of virtual care, urgent care, retail health and more
  • Advanced Practice Provider calculator to measure the impact of this workforce across specialties and their corresponding effect on physician supply and demand
  • Comprehensive, customizable reports with 5-year rolling projections and automatic annual updates to demand defined by demographic and geographic data
  • Archived reports providing strategic service area information and annual Stark compliance insights for measuring community need and assessing fair market value and commercial reasonableness considerations

Designed with the unique needs of leadership, physician and administrative stakeholders in mind, SullivanCotter’s PNA combines data-driven technology, industry-leading benchmark data and years of physician workforce consulting experience to provide organizations with the information and insights they need to inform key service line, practice and payer strategies in an evolving health care environment.

To learn more, request a demo, or view a full list of features and functionality, visit sullivancotter.com/PNA or call 888.739.7039.

About SullivanCotter

SullivanCotter partners with health care and other not-for-profit organizations to understand what drives performance and improve outcomes through the development and implementation of integrated workforce strategies. Using our time-tested methodologies and industry-leading research and information, we provide data-driven insights and expertise to help organizations align business strategy and performance objectives – enabling our clients to deliver on their mission, vision and values.


 

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INFOGRAPHIC | APP Leadership Practices and Structures

Leadership Structures to Support Advanced Practice Provider Retention and Engagement

Advanced practice providers (APPs) comprise one of the fastest growing workforces in the United States and are integral to effective and efficient health care delivery.

Organizations are developing APP leadership structures to create comprehensive workforce strategies that focus on APP optimization, workforce planning, recruitment, retention, engagement and ensure alignment with physician workforce strategies.

Learn more from SullivanCotter's 2019 APP Workforce Practices and Structures Survey.

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ON-DEMAND WEBINAR | COVID-19: Impact on Physician and APP Workforce Strategies

Positioning Your Organizations for Success in the New Normal

View an on-demand record of this exclusive webinar hosted by the Health Forum/American Hospital Association - featuring data, insights and industry experts from SullivanCotter.

VIEW THE RECORDING


The impact of the pandemic has accelerated the need for strategic alignment between health systems and their employed and affiliated physicians and advanced practice providers (APPs).

As the industry begins to look ahead and plan for financial recovery and operational transformation, executive leadership should take this time to reassess their organization’s alignment strategies and affiliation models in order to identify key workforce and care delivery optimization opportunities.

Working in partnership with physicians and APPs, organizational leaders are evaluating ways to best position themselves to manage anticipated increases in volume, navigate the transition to value-based reimbursement, and support long-term financial sustainability.

During this webinar, industry experts from SullivanCotter will discuss:

  • Physician and APP alignment strategies during and beyond the COVID-19 pandemic
  • Key components for enhancing strategic alignment between physicians, APPs and health systems
  • Leading practices in physician needs assessments and key considerations for primary care team optimization
  • Emerging trends in physician and APP compensation
  • The utilization of physician feedback and emerging performance management tools to aid in the development of core performance expectation and incentive plan metrics


PRESS RELEASE | SullivanCotter Launches Clinician Pay Functionality for PPMTTM

SullivanCotter Develops Powerful New Clinical Compensation Management Capabilities for its Growing PPMTTM Platform

September 1, 2020 – Chicago – SullivanCotter, the nation’s leading independent consulting firm in the assessment and development of total rewards programs and workforce solutions for the health care industry and not-for-profit sector, announces the addition of highly anticipated new Clinician Pay functionality to its growing Provider Performance Management TechnologyTM (PPMT) platform. PPMTTM is an industry-first, cloud-based solution that enables provider engagement through transparent performance-based compensation administration and analytical capabilities.

Clinician Pay enables administrative stakeholders to easily manage annual compensation draws and payroll adjustments through a centralized, secure and auditable source within PPMTTM. The new functionality can be added as part of the platform’s comprehensive Compensation Management Analytics module for an additional licensing fee. This module’s broader capabilities allow organizations to integrate physician compensation earned from all sources, review dollars paid and balances due, facilitate settlement reporting, project year-end results, model improvement scenarios and generate accruals for Finance.

“With this automated new functionality, health care organizations can significantly reduce manual intervention and potential for human error when managing important pay adjustments for a large clinical workforce. Not only does this help to free up administrators to work on more critical projects, but it also helps to ensure data quality and instill greater trust in the reporting process by seamlessly communicating important information straight to payroll for payment,” said Shelly Slowiak, Director, Product Support, Provider Performance Management Technology™

PPMT’s Compensation Management Analytics module plus the new Clinician Pay feature also provides the option to utilize payroll data for settlement processing - allowing for a comprehensive end-to-end solution for processing clinician payments and compensation adjustments.

“To help organizations navigate an increasingly complex and uncertain health care environment, we are continuously refining our product roadmap and enhancing PPMTTM based on the evolving needs of our clients. Clinician Pay is an exciting new addition to the platform and demonstrates our commitment to developing one of the industry’s most innovative clinical compensation and performance management solutions,” said David Schwietz, Chief Information Officer, SullivanCotter.

Designed to address a spectrum of physician, leadership and other key stakeholder needs, PPMTTM combines years of health care compensation insight and expertise with an intuitive and automated technology platform to help drive provider performance and support the transition from volume- to value-based care.

For more information on Clinician Pay or our entire suite of Provider Performance Management TechnologyTM, visit www.sullivancotter.com/PPMT or contact us at 888.739.7039.

About SullivanCotter

SullivanCotter partners with health care and other not-for-profit organizations to understand what drives performance and improve outcomes through the development and implementation of integrated workforce strategies. Using our time-tested methodologies and industry-leading research and information, we provide data-driven insights and expertise to help organizations align business strategy and performance objectives – enabling our clients to deliver on their mission, vision and values.


 

READ ON NEWSDIRECT