Survey: Physician leaders strongly support value-based care

Physician leaders strongly support the need to increase the value of healthcare services by improving quality while also lowering costs, according to a survey conducted by the American Association for Physician Leadership and the Navigant Center for Healthcare Research and Policy Analysis.

“Managed care executives clearly need to proactively develop and support physician leadership and management education,” says Peter Angood, president and chief executive officer, American Association for Physician Leadership. “By doing so, there will be more successful engagement of their medical staff and this will secondarily benefit various initiatives under way toward team-based care models.”

“Managed care is dependent on clinically integrated networks of physicians to manage care appropriately and efficiently, according to Paul Keckley, managing director, Navigant Center for Healthcare Research and Policy Analysis.

“The effectiveness of plans in these areas falls to physician leaders to appropriately measure and monitor appropriateness of care, define and incent physician behavior, determine and develop policies and procedures that align physician diagnoses and treatments with evidence-based practices, develop protocols for care coordination with their teams, and determine optimal mechanisms to enhance patient outcomes,” Keckley says. “These competencies require clinical training, leadership skills and business acumen-attributes of physician leadership addressed in the study.”

The comprehensive survey surveyed a total of 2,398 physician leaders across the country who are members of the American Association for Physician Leadership.

Next: The Survey Highlights

The survey highlights include:

• 55% of respondents said they agreed or strongly agreed that the Affordable Care Act passed in 2010 had “more good than bad” in it.

• 69% of respondents agreed or strongly agreed that physicians should be held accountable for costs of care in addition to quality of care.

• 57% of respondents agreed or strongly agreed that accountable care organizations (ACOs) will be a permanent model for risk-sharing with payers in years ahead.

• 58% of respondents agreed or strongly agreed that transparency about physicians’ business dealings is a positive trend for the profession.

• While 47% of respondents said their organizations conduct some kind of physician leadership development program, another 16% said they are aware of plans to create one.

• More than 90% of survey respondents agreed that reducing unnecessary care that is not evidence-based is an issue of high or very high importance.

When asked what business knowledge was necessary to be a successful physician leader:

• 63% of respondents agreed that knowledge in purchasing goods and services for the organization was important or very important.

• 65% considered knowledge in negotiating with lenders or investors to be important or very important.

• 78% said knowledge in evaluating risks associated with acquisitions or new businesses is important or very important.

• 90% of respondents said knowledge in understanding finances and access to capital is important or very important.

Next: Four survey takeaways

There is a significant move toward finding value in healthcare, according to Angood. “As a result, several types of initiatives are now underway; but are being oriented to avoid the same types of experiences that were learned from managed care in the early 1990s,” he says. “Physician engagement and integration are critical components for these trends as the percent of employed physicians expands. Defining effective physician leadership and clarifying the value of physician leadership are natural corollaries during this period of significant health care transition.”

According to Keckley, three catalysts are driving intensified interest among physicians to better equip themselves to be effective leaders in their organizations: increased risk-sharing arrangements between payers and providers requiring physicians to be accountable for both costs and quality, increased transparency in media and social networks about the variability of care provided by physicians, and heightened penalties by the Office of Inspector General and others for care that’s not medically necessary.

To that end, Angood and Keckley offer these four takeaways:

#1.Invest in physician leadership.

“Physician leadership is about much more than checking boxes for accreditation and credentialing providers to affiliate with their organization,” Keckley says.

#2. Physicians actually want to acquire additional leadership and management skills beyond their clinical training.

“They are able to effectively implement on these non-clinical skills once exposed and gain experience,” Angood says.

#3. Data are accruing that show when organizations are physician-led they often do better on several aspects of performance compared to others.

“Physicians with leadership and management skills are able to provide a dual benefit to healthcare delivery systems – their clinical acumen coupled with strong leadership skills is a dynamic combination that provides clear benefits,” Angood says.

#4. Provide the opportunity for training, tools and institutional support.