SullivanCotter’s Provider Affiliation and Optimization focuses on identifying, quantifying, and optimizing physician and advanced practice provider (APP) performance to improve provider productivity, engagement, financial results, staffing ratios, and overall efficiencies.
Our goal is to resolve areas of non-existent or suboptimal physician affiliation within health systems and improve patient outcomes, boost physician and APP care team collaboration, and support collective value-based initiatives and reimbursement opportunities.
Provider Affiliation and Optimization services encompass two types of work: Affiliation Services and Performance Optimization.
Affiliation Services and Performance Optimization work in concert as organizations seek to determine whether their investments in provider affiliations are meeting a market need, yielding optimal performance, and maximizing return on investment.
Affiliation Services are critical to a health system’s partnerships with providers. There is a continuum of affiliation models ranging from low levels of affiliation to full practice integration and employment, as illustrated in the same range of models set forth below.
SullivanCotter has extensive experience in the assessment, development, and implementation of these and other affiliation relationships between physicians, medical groups, and hospitals.
We enhance affiliation relationships by providing:
- Pre-affiliation due diligence (including potential review or update to provider needs assessments and workforce plans)
- Model selection (including an assessment to find the proper affiliation framework and recommended leading practice affiliation model characteristics, with tailored compensation and core performance expectations for your organization’s strategic alignment and accountability needs)
- Deal structuring (including aligning new or revised aligned compensation and benefits arrangements)
- Negotiation (including third-party facilitation or independent advising to one or more of the parties assessing new or revised affiliation relationships)
- Management and governance review assistance (including presentation of proposed terms, pro forma development, and other proposed performance requirements)
- Post-affiliation implementation (including implementation assistance, performance improvement assistance, performance management oversight and other facilitated communication and provider management assistance)
Performance Optimization is critical to the success of a health system’s business model and is based on a 5-step Performance Improvement Process. The comprehensive steps in the Performance Improvement Process include:
The Client Problems We Solve:
- Growth: Many health systems are currently experiencing stagnant market share growth. We provide clear strategies related to acquisitions, joint ventures, and other affiliation approaches to drive growth and increase provider engagement.
- Physician/Health System Alignment: Successful physician alignment with health systems and hospitals is necessary to improve patient outcomes, enhance patient access, and support value-based initiatives. We help clients select, develop and implement the affiliation model(s) that best meet their objectives.
- Financial Performance: With declining reimbursement and increasing costs per provider, health systems are under substantial pressure to find new ways to remain financially sustainable. Our performance optimization services help health systems assess, develop and implement targeted improvement solutions to improve financial performance.
- Operational Performance: Inadequate operational designs negatively affect medical group and/or service line performance. We support health systems with operational improvement solutions that promote provider productivity and engagement, improved patient access, revenue cycle improvements, staffing and cost efficiencies and overall medical group performance.
- Care Delivery Optimization: Sustainable models of care increase care delivery teams’ ability to enhance alignment, improve productivity, expand market share, control service line costs, drive financial margins and improve quality outcomes within a collaborative framework.
- Recruitment: Existing workforce plans evaluate current and future capacity needs to ensure the right long-term clinical staffing. We work with clients to develop and execute these workforce plans for actionable results.
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Provider Needs Assessment
Introducing SullivanCotter’s interactive
cloud-based application
As hospitals and health systems look to support growth and reassess cost and efficiency concerns in a rapidly evolving marketplace, access to current and projected market-specific physician supply and demand data is critical.
SullivanCotter helps organizations assess and develop a wide range of physician affiliation models - including those along the sample continuum below - from highly integrated to more modestly affiliated:
- Telemedicine and Area Referring Physicians
- Traditional Hospital Independent Medical Staff
- On-Call Coverage Relationships
- Physician Recruitment and Retention Support
- Medical Directorship and Other Professional Services Agreements
- Management Services Organization (MSO)/Practice Management
- Joint Managed Care (with lower levels of risk)
- Specialty Institute /Service Line and Program Co-Management
- Joint Venture and Shared Equity Relationships
- Clinical Integration and Payer Contracting (with higher levels of risk)
- Exclusive Foundation/Professional Services Agreement
- Full Practice Integration/Employment