Please be patient and bear with me! I promise to discuss how the business coaching of physicians leads to successful physician alignment, but first I need to lay some groundwork on the business structure of Accountable Care Organizations (ACO).
The Affordable Care Act encourages the formation of ACO’s where the participants in a patient’s care will share the payment for treating a patient based on the patient’s outcome success. So, rather than pay hospitals, physicians, and other ACO members for their individual portion of a patient’s treatment, the Center for Medicare and Medicaid Services (CMS) will instead pay one lump sum to all the involved participants for the bundle of services encompassing the entire episode of a patient’s care. Thus, the financial reward and the risk are shared collectively by all members of the ACO........ each individually must succeed in order for all to succeed. For example, a substandard performance by a single provider causing the patient’s outcome success to fall below the CMS benchmark will reduce the amount of money received by the ACO. Consequently, a poor performance by one member of the ACO, affects the profitability for all members of the ACO.
Due to this shared risk and reward, in the current issue of the Journal of Medical Practice Management1, I have proposed a new term to better define the ACO business structure. The term, Stakeholder Partners, is defined as a mutually beneficial relationship in which the organization and the stakeholder must partner in order for each to succeed. In the article, I discuss the critical and fundamental contrasts between physicians and other ACO members. Specifically, physicians are a group of individual heterogeneous entrepreneurs that tend not to act in a collective manner. This is in distinct antithesis to the other possible ACO members, such as hospitals, pharmaceutical companies, medical device, and yes, even medical insurance companies. These ACO members are well organized businesses with established strategic plans, communication systems and efficiency metrics. This contrast in organizational structure coupled with the financial interdependence of stakeholder partners in an ACO, makes it incumbent upon the organized members of the ACO to bring the physicians into the fold………..hence, the need for physician alignment! Thanks for bearing with the above bit of groundwork, now let me show you how business coaching leads to successful physician alignment. (The full article can be read at http://204.200.186.91/MedAchieve/Media_files/FINALSTAKEPART.pdf )
For purposes of this discussion, physician alignment means the sharing of common goals and values by the physicians with the hospital and other the ACO members. In order for physician alignment to occur, physicians must develop an organized structure to communicate and share data, comparable to the other stakeholder partners. The call for physician leadership omnipresent in healthcare attests to this fact; without physicians leaders there cannot be an organized physician structure! (In future postings, I will discuss a successful coaching model for developing physician leaders.) The sharing of data and ideas must take place internally in the physician’s component of the ACO, as well as externally between the physicians and the other ACO components. Because, in order to be a successful ACO, stakeholder partners must not only practice evidence-based medicine, but must share data to drive the efficiencies necessary within the entire ACO.
So, how does the business coaching of physicians improve physician alignment? Well, anecdotally I can attest from my own coaching experiences and those of my client physicians, that communication abilities markedly improve with business coaching. Or, we can examine the following 2009 study performed by PriceWaterhouseCoopers.2 A total of 2,200 clients from 64 countries were surveyed. Four benefits of coaching consistently noted have a direct bearing on the new skill set physicians must master for physician alignment: relationships, communication skills, interpersonal skills, and work performance (figure 1).
Fig. 1: Positive Impacts of Coaching
This bar graph of the ICF Global Coaching Study illustrates the positive impacts noted by the 2,200 participants. For example, 72% cited improved communication skills as a positive impact of coaching.
Clearly, the business coaching of physicians will improve their ability to communicate and work collectively internally as a cohesive group and externally with other ACO members.
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1. Cassatly M, Stakeholder Partners: The New Landscape
in U.S. Healthcare, J of Med Practice Management, vol. 26 (4),199-202, Feb 2011
2. ICF Global Coaching Client Study, International
Coach Federation, April 2009
