Thorough market assessment quickly pays off for physician network

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 - data mining

BEAVER CREEK. Colo.—Today’s healthcare system is fragmented and full of misaligned incentives, but it can be transformed with discipline, patience and adherence to evidence-based medicine, said Chris Lloyd, CEO of the Memorial Hermann Physician Network (MHMD) in Houston. “You have to go slow to go fast,” he advised.

Speaking June 20 at the MedAxiom Cardiovascular Service Line Symposium in Beaver Creek, Colo., Lloyd discussed strategies used to integrate MHMD, a network of nearly 5,000 physicians, with the goals of the Memorial Hermann Health System. The network relies on a compact that all physicians sign and follow that emphasizes accountability and high standards including evidence-based decision making and reporting quality data.

“It is like the Constitution to us,” he said.

Decision making should be deliberate and informed by evidence, said Lloyd, who is also CEO of the Memorial Hermann Accountable Care Organization. The network collaborated with payers, for instance, to obtain high quality data to assess costs and outcomes. That has served as the foundation for initiatives that have helped them identify shared cost savings, resulting in up to $16 million in incentive payments for physicians and hospitals.

He recommended a cautious approach when evaluating opportunities in the healthcare market, including co-management agreements. The marketplace offers a wide variety of partnerships, and by studying organizational dynamics, a network can identify what best complements its culture, provides a good fit, ensures quality outcomes and is financially beneficial.   

“There are a lot of things than can be done and there are a lot things with pitfalls associated with them,” Lloyd said. “We are very careful to go slow and evaluate: Is it the right time? Is the organization ready? Are we likely to be successful? … Have we looked at all the negatives and all the positives before we embark?”

The process requires a broad, strategic plan that clarifies priorities, processes and expectations. Developing a patient-centered medical home, for instance, required an understanding the rules underpinning the process and what physicians wanted to achieve. They devoted a year on analyses before initiating a patient-centered medical home.

Based on their evidence-based preparation, they met the needs of primary care physicians and had opportunities to perform data mining and help with scheduling. That allowed them to evaluate claims data faster.

“We got very quickly to transparent use of data,” he said. “What does that drive? Outcomes that allow us to go to market. We could have gone faster and missed the mark.”