A Case Study in Healthcare Integration: Hospital, Physician and Provider Strategy to Increase Patient Volume

June 1, 2010

With the demands of the healthcare reform bill, many hospitals, physicians and providers want to know what a successful integrated delivery system looks like. In a season of challenging economic times and management changes, to successfully achieve hospital-physician integration can set systems apart, and ultimately help increase patient volume.

Since healthcare integration attempts tend to fail more often than succeed, it’s vital to study someone who has done it right. St. Jude Medical Center is an excellent case study of a successfully integrated health network. This article published by Robert J. Fraschetti, the former CEO of St. Jude, and Michael Sugarman, M.D., president of St. Jude Heritage Medical, provided great insight on their integration strategy.

The premise of their article is this: shared governance and decision-making help healthcare systems thrive.

With increasing patient volume as my focus, I translated the article like this: healthcare systems have to adapt to reform in order to make increasing patient volume a sustainable objective.

Whether you’re a physician practice considering affiliation or a hospital leader or board member, there is something to learn from St. Jude’s success. While other integrated networks have collapsed, their integration has proven to be the exception. I encourage you to read more on their story, but here’s a quick snapshot of their strategic ideology.

Principles for Successful Integration

  • Interdependence is key.
  • Relationships are primary.
  • Trust takes time to develop.
  • Recognize and respect cultural differences.
  • Accountability and transparency are essential to maintain performance.
  • Medical groups must understand that the hospital has other relationships.



Increase Patient Volumes by Promoting Non-MDs

April 21, 2010

According to the American Association of Medical Colleges, America will be short of almost 50,000 Primary Care docs in the next 15 years. Wow. And you think it is hard to get an appointment now.

Shortages and rising costs will force us to do primary care with non-MDs like nurse practitioners and physician assistants.

Almost on a daily basis Evidence-Based Medicine is bringing standardization to protocols making it much easier for nurse practitioners and physician’s assistants to provide care that previously required a physician.

Similarly, technology advances will do the same to standardize some types of care and minimize the need for medical school training.

So what do hospital marketers do?

First of all, remember what your job is: you find ways to drive high-incidence high-contribution clinical intake.

So when a bottleneck in the system keeps you from filling beds, you must find innovative ways to unclog your flow of patients.

  • set up wellness events where at-risk patients can be examined and screened
  • any patient that fails an online screening should have the option to make an appointment with a non-MD practitioner for further examination
  • do public relations about the advances in the practice of healthcare as performed by NP’s and physician assistants
  • choose to feature non-MD’s in a portion of your advertising and brand messaging

Routing the patients into the system with a NP is a fast and efficient way to get patients into a specialist practice. For instance, that person that came to a seminar for orthopedic leg pain, may possibly have a CV problem instead- and an NP can route them correctly.

Oh, what if your Primary Care docs complain? They won’t, they are too busy.

Let me repeat: your job is to drive high-incidence high-contribution clinical intake. The way to handle the volume you will drive, is by promoting alternatives to physician-only primary care.



To Build Profitable Clinical Volumes, You Must Understand Health Care Reform Impact

April 14, 2010

Health Care Reform Insights From Harvard Business School Faculty – The Conversation – Harvard Business Review.

If you are going to do the radical things you must do to actually drive measurable Contribution Margin into your hospitals, you will have to better understand health reform legislation.

1) You can only be credible talking to your senior leaders if you are informed

2) You must begin modeling what is and what is not going to be profitable and then who and what you should target

This post from Harvard Business Review will take about 10 minutes to read. It is a good start in your understanding of the current situation and your thinking about the future of building profitable clinical volumes in your health system.