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Physician-hospital relationships

Every network and delivery model is unique

At A Glance

• Peer review
• ED call compensation
• Credentialing and privileging
• Managing disruptive and impaired physicians
• Bylaws review and medical staff governance redesign
• Executive and physician leadership education

Request more information about Physician-hospital relationships

Overview

Virtually every hospital is evolving toward a delivery model that includes a unique combination of employed physicians, contracted physicians and independent practice associations, and voluntary physicians in solo and group practices. The vision is clear. The financial and payer contracts are completed or well underway. The question is, how does the evolving network manage itself clinically and collegially for access, quality, and efficiency?

Our approach

The Greeley Company focuses on the operational issues facing any delivery network. How do network physicians work collegially and cooperatively with the hospital and each other, despite internal competitive concerns? Through what processes does the evolving network identify the right clinicians to participate in special quality-based contracts? How can the existing medical staff leadership model evolve in order to build trust amongst all participants? What are the quick wins, and what are the longer-term change initiatives?

Our perspective

Many hospital delivery networks are creating their own medical homes and accountable care contracts with commercial payers. We’ve observed that while many organizations have done a good job of designing financially-viable contracts, they’ve yet to prove that they can operate successfully within the contract to achieve their quality and patient satisfaction goals.

A number of our clients have struggled with the process through which they identify and recruit the right providers to participate in new networks—particularly if they are also dealing with trust issues. At several health systems, we’re using an approach unique to Greeley that enables hospitals and physicians to establish new relationships of trust and cooperation – and to accelerate the network recruitment process.

Our services

For 30 years, The Greeley Company has had a strong focus on the relationships between physicians and hospitals. More than ever before, The Greeley Company’s talents and tool sets are in demand as clients reevaluate and restructure their relationships with physicians. While others specialize in the financial and contractual aspects of these relationships, The Greeley Company focuses on the issues affecting the actual practice of medicine and on the coordination of care—the manner in which physicians deal with each other—regardless of the contractual relationship.

Some common challenges our clients face include:

• Enhancing effective relationships between physicians
• Maintaining physician satisfaction
• Implementing coordinated care models
• Evaluating physician competency
• Developing physician leaders
• Designing and implementing effective governance models
• Resolving physician-hospital conflict

The Greeley Company provides focused solutions in every aspect of physician-hospital relationships, including the areas below.

• Peer review

  • Peer review can be efficient and unbiased. Combining internal and external peer review approaches, The Greeley Company can help you to design and implement a contemporary peer review program, including such services as:

    • Creating multi-specialty peer review committees to improve efficiency and reduce bias
    • Optimizing available resources for effective focused professional practice evaluation (FPPE) and ongoing professional practice evaluation (OPPE)
    • Defining physician-specific indicators and targets for the six core competencies
    • Implementing physician performance feedback and management
    • Conducting peer review committee training and education
    • Training leaders on problem physician management

• ED call compensation

  • Paying (or not paying) for ED call can be a contentious issue. Based on our experience working with hospitals across the country, we can help you to:

    • Transform ED call compensation negotiations into a fair and constructive process
    • Improve EMTALA compliance
    • Measure the true burden of call for each specialty
    • Establish fair market value compensation by specialty
    • Determine when to move to a surgical or specialty hospitalist program
    • Utilize a physician employment strategy to help with ED call
    • Address other physician-hospital issues that are inflaming ED call
    • Handle physicians limiting their privileges to avoid ED call
    • Deal with physicians failing to respond to ED call pages
    • Implement a policy that ensures the medical staff fulfills its responsibilities for ED call
    • Improve physician-hospital relationships while addressing ED call

• Credentialing and privileging

  • The Greeley Company combines the expertise of industry-leading medical services professionals and physicians who focus solely on working with hospital and medical staff leaders to drive cultural and system changes and improvements. We regularly help clients:

    • Deal with difficult issues like temporary privileges, low-/no-volume practitioners, cross-specialty privileging disputes, employed physician conundrums, and the credentialing and privileging of advanced practice professionals
    • Win physician buy-in and support for key initiatives, such as implementation of criteria-based privileging
    • Successfully implement facility-specific, criteria-based core or cluster privileging
    • Defend and support credentialing and privileging decisions in situations involving corrective action, fair hearing, or litigation—providing witness testimony as necessary
    • Develop medical staff leadership by strengthening their skills, increasing knowledge, and providing strategic direction
    • Protect patients as your organization introduces new technology and services
    • Create a high-functioning medical staff services department

    
    Interim staffing

    Our diverse pool of medical services professionals—covering all levels from director to credentialing specialist—are knowledgeable, skilled, and can hit the ground running. And they’re backed by the best in the business—Sally Pelletier, Carol Cairns, and the many other medical services professionals and physician experts from The Greeley Company whom you know and trust. We can quickly identify and deploy professionals with the appropriate backgrounds to fulfill your specific needs.

    Here’s a sample of the types of services our staffers can provide:

    • Process initial appointments, reappointments, and privileging requests
    • Conduct a “SWAT” clean up of your credentialing database and credentials files
    • Manage and support medical staff meetings
    • Recruit, train, and manage medical services professionals
    • Validate and audit credentials files to ensure survey readiness

• Managing disruptive and impaired physicians

  • The Greeley Company has helped dozens of hospitals resolve urgent and chronic behavioral issues. When you need assistance confronting a disruptive physician, we can help you assess the situation, carry out an intervention on your behalf, and provide the tools you need to follow up. Our services help you to:

    • Achieve medical staff buy-in to your policies for preventing and dealing with disruptive behavior
    • Train medical staff leaders to carry out interventions in a sensitive and nonconfrontational manner
    • Improve patient safety with a consistent model for professional conduct
    • Strengthen your professional conduct policies and procedures
    • Stop unprofessional physician behavior at the door through good credentialing
    • Take corrective action, when necessary, that limits a physician’s membership and privileges
    • Address systemic causes of chronic behavioral issues

• Bylaws review and medical staff governance redesign

  • Recognizing that bylaws are not just words on a page, but potential sources of conflict, resistance, and fear, The Greeley Company can help you to:

    • Work through thorny bylaws issues
    • Reorganize medical staff governance to reflect contemporary models
    • Create state-of-the-art, regulatory-compliant bylaws to better reflect medical staff organization and function
    • Revise the bylaws and related documents to be clear, concise, compliant, and up to date
    • Implement the medical staff culture change that is necessary for success

• Executive and physician leadership education

  • The Greeley Company offers on-site educational programs and national seminars for hospital and physician leaders. These programs provide cutting-edge strategies and tools for dealing with traditionally difficult areas, as well as practical, actionable strategies for the most challenging new issues.

    The Greeley Company’s extensive network of experienced hospital executives, physician leaders, and healthcare attorneys can design an educational program to meet your requirements. Contact us to discuss your educational needs and how we might help. Call (888) 749-3054 or email tgc@greeley.com.