Addressing 3 Common Physician Alignment Challenges

physician treating patientPhysician performance significantly affects patient experiences, loyalty, and lifetime value. When physicians deeply engage and align with your health system, the result is better patient interactions and greater loyalty to your network.

In fact, alignment can make the difference between reaching organizational goals or failing to. With the right strategy, physician alignment leads to:

  • More in-network referrals
  • Increased revenue
  • Service line growth
  • Improved patient experiences
  • Better relationships between physicians and health systems

To develop these positive relationships with providers, health systems need to run focused outreach programs. These programs must understand behavior, create a dialogue between physicians and organizational leadership, and work through pain points that may be inhibiting alignment.

While the need for effective physician alignment is nothing new, many health systems still find achieving it troublesome. In this post, we examine three of the most common challenges healthcare organizations face and tips to overcome them.

Challenge 1: Closing the Loop on Provider Issues

Aligning physicians requires sophisticated and consistent issue tracking, proper escalation, and workflow management. Physician liaisons, who often act as intermediators between health systems and providers, must be able to easily log their interactions with doctors and flag resulting issues.

Physician relationship management (PRM) software combines issue management, liaison notes, and market intelligence across your network of providers. Capturing these insights facilitates significantly more focused subsequent interactions with providers.  

But, a PRM doesn’t just record provider issues; it also must have built-in workflows that seamlessly notify responsible parties of a raised concern, setting in motion a programmatical sequence of events to resolve the issue. These capabilities help liaisons to close the loop with physicians. A liaison can go back to providers and discuss how they raised their issues, how the health system addressed them, and how processes will change for the better moving forward.

Based on extensive experience, we believe if liaisons can demonstrate this closed-loop issue resolution three times with a specific provider, they gain greater engagement, loyalty, and satisfaction from this physician, resulting in downstream business.  

Challenge 2: Identifying Leakage Points

Leakage, or some might same less than desired ‘keepage’, happens when physicians refer their patients to out-of-network providers, meaning patient revenue moves out of your aligned care delivery network. This is a major financial burden on health systems; two in five healthcare executives recently identified they were losing 10 percent of their annual revenues due to leakage.

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The same study found only 34 percent of health executives said they have a handle on where and why leakage occurs. Addressing this issue requires alignment; Gallup found that aligned physicians gave their hospitals 51 percent more in-network referrals than unaligned physicians. 

Historically, liaisons were simply relationship-builders who would visit physicians to learn their overall sentiment towards the health system and try to chronicle it. While strong interpersonal relationships are a great thing, this strategy made it challenging to effectively move the needle on closing leaks. That requires greater interaction specificity guided by market intelligence.

Think of it this way: if liaisons initiate highly specific conversations with physicians, that’s the difference between asking generally “how are things going?” and asking “What are the circumstances under which you prefer to refer your cardiology patients to Dr. Smith?” Or, “What are some of the differences in care delivery that result in you referring to our orthopedic surgeons but not as frequently to our cardiology or oncology specialists?”

Consider the answers you’d receive to these two questions. To the first, you would most likely get “things are going well.” To the second, you’re more likely to receive an actionable response, “I’ve referred my orthopedic patients to [the in-network specialist] and that’s been fine, but my patients have complained about wait times for appointments and an overall poor experience with our cardiology specialists, and I’ve heard the in-network oncologist prescribes lots of overly-aggressive radiology tests instead of taking a step by step approach.”

This more detailed response produces a wealth of actionable data liaisons can document in the PRM and take back to the health system, setting real change in motion that will result in greater numbers of in-network referrals. Over time, if rigor in documenting issues that prevent or reduce alignment is maintained in a PRM, general hearsay becomes quantifiable metrics and facts.

Challenge 3: Tracking ROI of Alignment Efforts

doctor with good news for female patientTypically, calculating a form of return on investment (ROI) of physician alignment meant defining the reach and frequency of provider interactions and chronicling feedback on a wide range of issues.

But monitoring real ROI of alignment efforts is a complex, multi-step process.

To track ROI successfully, health systems need to record liaison interactions, capture provider feedback, and have access to before and after metrics of provider performing and referring activity.

For example, to track the success of outreach aimed at increasing referrals from credentialed providers, you need visibility into the number of cases each provider is referring to you versus your competitors:

Say a credentialed provider currently sends 100 cases to your health system per month, but after three months of targeted alignment efforts (such as introducing them to new in-network providers), you see their referrals increase to 130 per month. Having both historical and real-time data, coupled with an understanding of the net value of each case, allows you to truly attribute and understand the value of outreach efforts. Further, it is often useful to measure not just your own net increases, but contrast that to the overall referring activity of the provider in question. For this, you need an accurate claims-based market analytics solution.

PRM and EHR integration is certainly one key to tracking the ROI of alignment efforts, since critical referral data can be often stored within the EHR. PRM integration allows you to build robust reports using real referral data in combination with liaison activity data, thus tying changes in referral patterns back to specific liaison efforts. It is important, however, to ensure that the referral data captured within an EHR is as accurate as possible. We find it is often a great catalyst for data quality improvement if a physician outreach team and leadership becomes a change agent driving and striving for this.

Final Thoughts

Robust physician alignment programs can contribute significantly to revenue growth and targeted service line improvement. One large hospital system found that the impact of alignment activities delivered a contribution margin of $31M in a single fiscal year, an ROI of 10.6:1.

To align physicians successfully, you need to stop using rumors and hearsay to understand physician sentiment and start leveraging concrete, actionable collected data inputs, along with robust overall market intelligence. In other words, moving from what could be called “anecdotalytics” to having real analytics.  

Emilio Ruocco

Emilio Ruocco

Emilio serves as Evariant’s Vice President, Physician Practice leader, ensuring the company’s Healthcare CRM/PRM, business intelligence and marketing solutions deliver maximum strategic value to clients; with particular emphasis on physician market analytics and business development. Prior to joining Evariant, Emilio was Senior Director, Performance Technologies at The Advisory Board Company, helping hospitals yield operational insight from internal systems and external data sets. He has also served as Leader of Customer Value and Insights at Healthways, a leading disease management and wellness firm; and Vice President, Strategic Communications for pharmacy benefits management company CaremarkRx, prior to its merger with CVS Pharmacy. Before entering the healthcare sector, Emilio held business development, investor relations and communications leadership roles for several public companies in a variety of industries.
Emilio Ruocco