Strategic Planning in Today’s Rapidly Changing World of Healthcare
At a recent engagement, we were privileged to participate in a discussion conducted by members of the medical staff represented by a variety of specialties regarding the future of healthcare and particularly the future of their hospital paying for unassigned emergency department call coverage. Also participating were the CMO and COO of the hospital.
It was a lively exchange where a variety of prognostications were expounded such as national and local trends as well as various perspectives of the prevailing orientation of healthcare delivery. After about an hour it was obvious that there were at least ten very strong positions expressed by this esteemed group of physicians, however no consensus was ever reached as to the future of healthcare or paying for call.
While long-range strategic planning is necessary, the pace of change, the lack of clarity from various industry leaders, and the instability of the political and economic landscape, pose a challenge to the traditions and reliability of planning and forecasting. What was once primarily a science has since transformed into an art form in the world of long term strategic planning.
Considering that few facts are known and that healthcare’s future is unpredictable, we encouraged the group to take a more flexible approach. Rather than viewing the planning process as a “motion picture” moving across time and into the future, we stressed the importance of fundamentally approaching the issues surrounding paying for ED call coverage as a “snapshot” of the current situation. Through this process it is important to identify “soft landing” spots for various defined scenarios.
The old adage that “the only thing new is the history we don’t know” isn’t exactly relevant in a planning environment today. We don’t need a forensic accountant to understand that it doesn’t make economic sense for a private practicing physician to invest time and resources into covering unassigned patients in the hospital’s emergency room without being compensated for being available to take call.
These are “known” or the “facts” which we must consider today: The limiting parameters surrounding call pay primarily involve “affordability”. Going beyond affordability we have contributing factors such as fair market value, relative burden and community need. Furthermore, infused into these complexities are issues involving healthcare related laws defining hospital/physician financial arrangements.
We believe that the starting point is a realistic assessment of burden and emergent need. Regardless of how the future is defined, communities need to have qualified medical professionals providing specialized emergency medical care. For many of those physicians providing that care, there is a legitimate justification for being paid for their services. We can debate the future and invest hours in scenario forecasting but a “snapshot” of reality deserves immediate action.
The key is to build flexibility into the solution that allows for the significant changes that may take place in the future. If the immediate needs are properly assessed and the budget is fairly allocated, there are options that can be exercised to adjust for the changes that are not exactly known but are inevitably forthcoming.
Our trademarked approach, referred to as the Call Pay Solution®, is one systematic turnkey approach that establishes the basis for flexibility and “soft landings”. Whether an employment culture is instituted or the move to integration dominates, emergency medical care is certainly not going to disappear along with the need for professional services. If call compensation is cast into the form of an executive benefit as it is in the Call Pay Solution®, the hospital will have the tools to bridge physicians monetarily into employment status. As quality measures become more transparent and a dominant factor of reimbursement, quality factors are easily inserted into the compensation formulas of an “executive benefit” approach to call pay. And, if clinical integration dominates the landscape, the well-designed call pay program may be modified into an incentive rewards structure to recognize quality and efficiency of care.
Therefore, we believe that strategic planning should be revolutionized and approached more as a snapshot with soft landings as opposed to investing valuable time and resources in futile discussions about defining the future. The need is now and with qualified professional assistance, hospital and physicians can align their interest and become “partnership centric” as we navigate the uncertainty that lies ahead.
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