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.


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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WEBINAR | The Impact of the Changing Health Care Environment on Primary Care

Is your organization struggling to address the impact of COVID-19, changes to the Stark Law and updates to the Physician Fee Schedule?

Tuesday, April 27 |  10-11am CT

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Hosted by the American Association of Provider Compensation Professionals (AAPCP)

Prior to the onset of COVID-19, the changing reimbursement environment and transition to value-based care were impacting primary care compensation design and pay practices. Today, as health care organizations nationwide are navigating an increasingly complex operating environment, COVID-19 continues to place pressure on financial sustainability, patient access and population health management.

Combined with changes to the Physician Self-Referral Law (Stark) and updates to the 2021 Physician Fee Schedule and Evaluation & Management CPT codes, health care organizations are rapidly engaging in the redesign of their primary care compensation programs.

During this session, SullivanCotter will highlight relevant market trends impacting contemporary primary care compensation design and discuss evolving plan methodologies and approaches as organizations plan for the future.


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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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.


 

READ ON NEWSDIRECT


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


Case Study | Optimal Use of APPs Can Help to Enhance Post-COVID-19 Financial Recovery

Featured in the July edition of hfm Magazine

As hospitals and health systems plan for post-COVID-19 recovery and operational transformation, the focus on optimizing care delivery, lowering expenses and increasing revenue to ensure financial sustainability will be critical.

Enhancing the use of existing clinical resources can help to support these goals. As part of this effort, leaders should make it a priority to reassess the role of advanced practice providers (APPs) given their extensive training, broad skill sets and ability to adapt to different practice settings.

In their work with SullivanCotter, learn how Excela Health's efforts to optimize their APP workforce yielded millions in financial opportunity - proving valuable during their COVID-19 response and recovery plan.

READ FULL ARTICLE


INFOGRAPHIC | Redeploying CRNAs During COVID-19

Helping to meet critical patient needs

Are you considering the redeployment of CRNAs during the COVID-19 pandemic?

Organizations need an intentional and thoughtful strategy for CRNA placement and utilization.


As the COVID-19 pandemic continues to evolve, health care leaders nationwide are looking for better ways to address surging patient volumes. Certified Registered Nurse Anesthetists (CRNAs), with experience in rapid systems assessment, airway management, fluid resuscitation and general anesthesia delivery, have proven to be a valuable resource in providing critical care to the influx of COVID-19 patients.

Redeploying CRNAs outside of traditional operating room roles can equip organizations with a much-needed critical care workforce to help manage growing patient volumes and support innovative care delivery.

DOWNLOAD INFOGRAPHIC


INFOGRAPHIC | Tools for Redeploying Advanced Practice Providers During COVID-19

Many health care organizations have redeployed advanced practice providers during COVID 19 to meet evolving patient needs.

Considering both the short and long-term elements of this strategy can help to ensure success.


Redefining the care delivery team is critical to meeting important patient needs in a rapidly changing health care environment. Advanced practice providers (APPs) can be a valuable resource in helping to accomplish this given their extensive training, broad skill set, and ability to adapt to different practice settings.

Redeploying APPs can be an effective way to manage growing patient volumes, maintain financial stability and support emerging care delivery models such as telemedicine.

DOWNLOAD INFOGRAPHIC


PRESS RELEASE | SullivanCotter Launches Suite of Health Care Benchmarking Solutions

SullivanCotter Launches Innovative Suite of Products to Help Benchmark Health Care Workforce Compensation and Clinical Productivity

READ ON PR NEWSWIRE


July 30, 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, is pleased to announce the launch of Benchmarks360TM. Powered by SullivanCotter's proprietary survey data and research, Benchmarks360TM is a suite of intelligent, web-based products that enables health care organizations to analyze and visualize workforce compensation and clinical productivity.

Designed to address enterprise-wide benchmarking needs for employees at all levels – including executives, physicians, advanced practice providers and other clinical and non-clinical staff positions – Benchmarks360TM provides critical industry-leading data, analyses and reporting to support the compensation decision-making process in an increasingly complex operating environment.

"Amidst a rapidly evolving global pandemic, hospitals and health systems are struggling to navigate a number of unprecedented financial and workforce challenges. Strengthening compensation practices and clinical workforce productivity through unique, data-driven intelligence and insights can help to support long-term sustainability in today's ever-changing marketplace. With the ability to conduct a wide variety of quantitative reviews and custom benchmarking analyses, Benchmarks360TM allows organizations to interactively assess clinical productivity and changes in compensation against national market data," said David Schwietz, Chief Information Officer, SullivanCotter.

As one of the most comprehensive products of its kind, it includes two distinct modules to help balance pay and clinical productivity across the organization:

Workforce Compensation and Clinical Productivity Manager

Compare your organization's compensation and clinical productivity benchmarks to the nation's largest health systems and medical groups. Utilize SullivanCotter's proprietary benchmarking information, representing over one million total incumbents, along with other third-party data sources. This module comes in both a Standard (offered with the purchase of SullivanCotter survey data) and a Pro version (upgrade available for additional licensing fee).

Clinical CPT Manager

Analyze and measure your organization's Current Procedural Terminology (CPT) coding distribution against national physician and advanced practice provider clinical benchmarks at the specialty, work RVU and CPT level. This module can be purchased and added separately.

Benchmarks360TM is offered exclusively to organizations who purchase SullivanCotter survey reports. To learn more, 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 and expertise to help organizations align business strategy and performance objectives – enabling our clients to deliver on their mission, vision and values.


PODCAST | Impact of COVID-19 on Physician and APP Compensation Practices

BESLER | The Hospital Finance Podcast®

LISTEN TO PODCAST

Zach Hartsell, Principal, discusses some of the results from SullivanCotter's 2020 COVID-19 Physician and Advanced Practice Provider Compensation Practices Survey on the July 29, 2020 episode of the The Hospital Finance Podcast® with BESLER.

Highlights of this episode include:

  • Background on SullivanCotter's COVID-19 survey series
  • How organizations are handling furloughs and layoffs during the pandemic
  • How cash compensation and benefits have been affected by the pandemic
  • What are organizations looking at in terms of salary protections and incentive compensation for physicians?
  • Some trends around redeployment and premium compensation for advanced practice providers

TRANSCRIPT

 

Mike Passanante: Hi, this is Mike Passanante and welcome back to the award-winning Hospital Finance Podcast®. Consulting firm SullivanCotter recently released survey results indicating that organizations are anticipating changes to physician non-productivity-based incentives in 2020. To discuss the study results, I’m joined by Zachary Hartsell, a principal at SullivanCotter. Zachary, welcome to the show.

Zachary: Michael, glad to be here. Thank you for inviting me.

Mike: Today we’ll be talking about the results of SullivanCotter’s COVID-19 Physician and Advanced Practice Provider Compensation Practices survey series. What were you looking at, specifically, in this survey? And who did you survey?

Zachary: Well, happy to discuss it, Michael. SullivanCotter has actually conducted two surveys on this topic, one in April and one in May. We conducted these survey to provide insight to our clients and to the market as to how organizations were responding to the pandemic from a workforce and total rewards perspective. Both surveys had over 100 participants, and we saw a 70% repeat in participation from the first to the second survey. Participating organizations had annual net revenue ranging anywhere from 400 million to 28 billion -  representing many of the largest integrated, academic and pediatric hospitals and health systems in the country. The goal of the survey was to understand the changes that occurred or are being considered as it relates to physician and APP compensation practices. When we think about compensation, we think not only about cash compensation, but things like incentives, premium pay, and benefits. We also wanted to understand what kind of compensation plan changes organizations were considering as a result of the different workflows in response to the pandemic, such as redeployments, closed clinics, etc.

Mike: Got it. So let’s dig into something you just said there. What are you finding organizations are doing in terms of furloughs and layoffs at this point?

Zachary: Great question, Michael, and something that we often get. Contrary to the attention-grabbing headlines, most organizations are not furloughing or laying off their employed physicians or advanced practice providers. In fact, less than 10% of survey respondents had implemented layoffs or furloughs. What we’re seeing in place of that is nearly half of the organizations are instead reducing physician and/or APP compensation or considering changes to benefit programs like retirement plans, CME, etc. For the minority of organizations who have looked at furloughs or layoffs, the consistent trend we are seeing is that organizations are focusing more on temporary furloughs rather than layoffs, which seem a little more permanent. Additionally, these changes are impacting the staff physicians and APPs more than they are the APP or physician leaders. When we look at organizations that have implemented furloughs, on average, the duration lasts anywhere from about three to four weeks. I will say, though, since our survey release, through conversations with our clients and media reports, we are seeing an uptick in the need to have, in some markets, more workforce actions like furloughs and layoffs due to the continued financial strain and the lack of patient volumes. But this really varies market by market and organization by organization. In our experience, it seems to be in part due to the pre-COVID financial health of the organization. I think this will be really important to monitor in the coming weeks and months, as we hit additional surges and/or volumes don’t return as projected. And if that were to happen, we could see an increase in the prevalence of furloughs and layoffs. Whereas if volumes return greater than expected, we are going to see more returning to work and even potentially new hiring.

Mike: That would be optimal. Zachary, how have you found cash compensation and benefits? How have they been affected?

Zachary: We’ve been seeing changes in the way organizations are handling compensation of their APPs and physicians as a result of COVID. But it’s not just the COVID pandemic, it’s also the economic fallout from that. And again, like with furloughs and layoffs, these changes are occurring with a lot of variability and are really dependent on the degree of disruption the organization has experienced and the pre-COVID financial health of the organization. Now, within this, we have seen some things that we expect, and we’ve seen some surprises. For example, one surprise was that we have not seen a lot of premium pay for physicians or APPs working in frontline areas with only 10% of organizations reporting that they’ve considered or have implemented premium pay compensation. This was something that we were expecting a lot more of. Compensation protection for physicians were expected, and we see them present. As of May, about half the organizations implemented or were considering temporary compensation floors - and this is for the non-frontline physicians. This is understandable given the continued loss of volume and the loss of patient revenue. Interestingly, though, while half of the organizations were protecting physician compensation, this number actually decreased from the April survey by about 10% - indicating that some organizations that may have offered initial protections had lifted those protections. Benefits are another area where we are seeing organizations making changes. In our May survey, about 35% had implemented or were considering changes to benefit programs such as reducing or eliminating retirement plan contributions, reducing or eliminating CME funds or time off, or reducing PTO time.

Mike: Zachary, let’s talk specifically about physicians for a moment. What are organizations looking at in terms of salary protections and incentive compensation for them?

Zachary: As I mentioned above, it really is dependent on whether they were frontline providers– and I mean ED, critical care, hospital medicine, or non-frontline. As we said, for frontline providers, we saw very little in the way of premium compensation. For the organizations that did use a premium, we have seen a bit of an interesting shift. Initially, those were all applied as a percentage increase to the shift rate. But as financial situations have evolved, the structure of those premium payments has changed to a one-time stipend or bonus. We talked about non-frontline physicians and about half of organizations having cash compensation protection for physicians experiencing a loss of shifts or productivity as a result of the decrease in elective procedures or non-emergent visits. When you break down the detail and you look at the scope of the protection, about 40% of organizations were providing about 100% of historical cash compensation protection, about 40% were protecting between 75 and 90 percent of historical compensation, and anywhere from 5-15% were protecting somewhere in the neighborhood of 50-75% of historical compensation. So there was a significant amount of protection being offered. As organizations begin a slow recovery out of the COVID crisis and as people start to think about how they reconcile the health system financial sustainability, I think that these compensation protections are going to be more in the limelight. As we said, organizations are starting to lift them a bit and I think as protections linger on, or market conditions create the need for subsequent protections, we’ll likely see that the increase of organizations requiring repayment of these – currently it’s about 22%. But as this continues on, we may see more and more organizations requiring repayment. One last thing to talk about with physicians would be the incentive component. And when we talk about incentive, nearly 40% of organizations plan to modify physician incentive plans for the remainder of 2020. When we talk about incentives, though, in this context, we are specifically talking about non-productivity incentives - things such as value-based incentives or the system-wide incentives that physicians are eligible for, not the productivity incentives that we spoke about earlier. Additionally, about a quarter of organizations anticipate making future changes to the physician compensation plan as a result of the fallout from COVID-19.

Mike: Zachary, the work of many advanced practice providers was affected by COVID-19. Tell us about the trends you saw around redeployment and premium compensation for those providers.

Zachary: Well, as we discussed earlier, Michael, this is really interesting to me, being an advanced practice provider myself. I think that this has really been one of the "aha" moments organizations have experienced as a result of COVID - and that is the value that the flexibility of the APP workforce. For example, 71% of organizations have redeployed or plan to redeploy their non-frontline APPs into frontline specialties. And I’ll tell you anecdotally, that’s not just the ICU or hospital-based units. But it’s things like COVID screening clinics, telemedicine, infectious disease, and pulmonary medicine clinics. A critical consideration for organizations looking to redeploy their APPs is ensuring that they’re redeploying the APPs with the right skill set. This is incredibly important and can’t really be overlooked. This is often best accomplished through performing an organization-wide skill inventory of your APPs. Other important considerations when thinking about redeployment include clarifying emergency credentialing policies, reviewing staffing plans, and providing training for new care delivery and documentation requirements. On the compensation side, about half the organizations have made reductions to cash compensation with the average reduction of approximately about 10%. While APP incentive programs are not as common as with physicians, in our survey, about two-thirds did say that they have incentive plans. This is higher than what we typically see. Our May survey indicated that about a quarter of them were modifying their incentive plans. When we break down the data, that was fairly evenly split between modifying the plan, reducing the plan, or eliminating the incentive opportunity altogether. I think what we’re starting to see now is organizations thinking about the future. In our May survey, about 15% of organizations anticipated making changes to future APP compensation, as a result of COVID-19, with another 47% unsure. As the pandemic continues and as there is more clarity around the financial situation post-pandemic, I suspect we’ll have more organizations making decisions about whether they will be making future changes to APP compensation.

Mike: Do you have any recommendations for organizations that are revisiting their compensation packages for physicians and APPs as a result of the pandemic?

Zachary: This really may be a crossroads for physician and APP compensation as COVID-19 will serve as a referendum on the traditional compensation programs. We imagine that there will be organizations who will use this disruption to escalate the movement away from productivity-based compensation to more performance-based compensation. I’ll tell you, though - there will be other organizations that will see this as an opportunity to double down on productivity in order to try to see a quick financial recovery. I think for all organizations the overall question is, “Can you afford to return to the old model? Or is this time of disruption a chance to reset using a different formula?” I think the challenge that most organizations will face is how to make these long-term decisions when there are still so many unanswered questions. "How long will the COVID disruptions last? What’s going to happen to telehealth and the payments? What impact will the rise of the uninsured be on organizational finances?" And something else that has not been discussed as much but will have a big impact is the impending CPT coding changes and how these changes will impact organizational finances and physician compensation in the future. As healthcare organizations attempt to plan for these uncertainties, there’s going to be a need for more efficient operating models. I think there’ll be some right-sizing of cost structures and the reassessment of organizational processes and structures to become a little more clear. I think organizations should be thinking about taking inventory as, “Do you have a clear and consistent base performance and work expectations for all of your physicians and APPs? Do you have physicians and APPs working at the top of their license and training and aligned with desired outcomes like patient access, throughput, and quality? Do you have a compensation philosophy and a model for physicians and APP that is aligned with organizational goals, that is equitable, externally competitive, efficient, and easy to administer?" And most importantly, "Is it understandable to the physicians and APPs?" A clear compensation strategy that is paired with a clearly-defined performance and clinical work expectations are the critical components that leaders can utilize to hold the clinicians accountable, differentiate performance, and in turn, compensation in the future. As the COVID-19 pandemic continues to evolve, we will continue to monitor the market and provide updates to the trends we shared here today. I think these trends are important to keep an eye on and for organizations to consider while they’re analyzing their own compensation plans and financial positions.

Mike: Zachary, if someone wanted to read more about the study results, where can they go?

Zachary: Go to www.sullivancotter.com and look under our resources page. You can also follow SullivanCotter on LinkedIn, where we regularly post compensation trends and insights related to COVID-19 and physician and APP compensation. Finally, I’m happy to answer any specific questions at zacharyhartsell@sullivancotter.com.

Mike: Zachary Hartsell, thanks so much for stopping by today and talking with us on the Hospital Finance Podcast.

Zachary: Thank you again, Michael. I appreciate the invite.