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A sample of Gap Analysis - ACO Client

Updated: Aug 21, 2020

Creating an exceptional physician experience from recruitment to successful onboarding, from practice development to retention within Healthcare Organizations is critical to the organization's success.


Key strategic priorities:

  • Clinical Integration

  • Population Health Infrastructure

  • Efficient Care Delivery

Cultural goals and focus areas:

  • Transformative Change

  • Accountability

  • Teamwork & Collaboration

  • Engagement & Experience

Situation

As Healthcare Organizations continues down the path of accountable care & population health, physician engagement and the success of a highly reliable and integrated medical group are key strategic imperatives. The recruitment and retention of physicians are critical to the organization’s success. To that end, a need has been identified to re-engineer and implement a streamlined and consistent process from recruitment to successful practice development in a new physician’s first year.


Our current state of medical staff credentialing and on-boarding process along with the payer enrollment process does not provide a positive experience and seamless introduction to Healthcare Organizations. Recently, several of our new physicians have expressed difficulties and frustration at several points in the process and the redundancy surrounding this process. Inability to market themselves effectively to referring physicians and colleagues also plays a major role in physician satisfaction.


The negative impact on physician practice development and retention is considerable. In addition, the financial implications and opportunity costs are significant and rising due to a lack of staffing. Other organizations that have quantified the loss associated with poor physician onboarding practices have estimated a $2-4M annual opportunity for improvement.


The medical staff has credentialed 36 new providers in June and July for whom enrollment applications have not been submitted. Quantifiable data was not available for these 2 months of opportunity loss (June – July 2018).


As of May 2018, our estimated loss for not staffing payer enrollment and payer relationship management department is estimated at .7M. The staffing is still not in place as of July 28th, 2018. An agreement is in the final stages of approval with a vendor and then staffing will be sourced. The anticipated date for the payer enrollment department to be staffed with temporary staff is August 20, 2018, at the earliest - 3 months without staff).


Recommendations

Physicians are at the heart of the organization’s success. Developing a positive organizational culture coupled with a strong administrative & clinical leadership commitment to providing an exceptional credentialing and onboarding experience is essential.


The immediate next step is to review this comprehensive approach with a group of key leaders & stakeholders for feedback and buy-in/support. It is recommended that with senior leadership endorsement, the following action items are considered and addressed/approved in the appropriate forum(s) and an associated implementation plan is established:

  • Streamline & refine physician recruiting, privileging, credentialing, onboarding and marketing outreach processes – make it easier and simpler for Physician to work

  • Develop & implement a System-Wide Approach to Physician/Provider Credentialing & Data Management by adopting a centralized model. One application for all hospitals

  • A system-wide repository and source of truth for physician data – create a provider “golden record”; Ensures appropriate and accurate data flow to key access (e.g. billing, EMR, physician directory, payer credentialing) as well as other systems

  • Initiate the Onboarding Process within 24 hours of contract signature with a Physician Navigation Specialist to provide physician 1:1 touchpoint throughout their first year

  • Practice Management team to proactively define Physician onboarding infrastructure set up requirements (i.e., IT, Security, Badge, Facilities, etc.) & other requests submitted 6 weeks prior to starting dates

  • Physician to have an onboarding roadmap with mutual expectations to be shared between Physician, Physician Navigations Specialist, Practice Manager, and Medical Leadership 3 weeks in advance of the start date

  • Development of a comprehensive physician outreach and marketing/communication strategy with aligned resources

  • Determine leadership of the on-boarding and retention program (new hire = one project)

  • Clarify roles and responsibilities within the interdepartmental/interdisciplinary team

  • Commit to a culture of accountability and responsiveness

  • Initiate a forum for all new Healthcare Organizations Physicians to meet and interact regularly around orientation and enculturation topics, meeting senior leadership, etc.

  • Medical Leadership to conduct quarterly Physician 1:1 touchpoints throughout the first year to ensure high engagement, satisfaction, and retention of our Physicians




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