Physician-Hospital Alignment and Compensation Models: The Second Generation
Paperback
The current era of healthcare alignment among physicians, hospitals, and outside independent investors has been underway for 10-15 years. Given this, many of the original contracts that formed the basis of these arrangements have (or will soon) expire. Thus, we refer to these new deals as “second generation” transactions.
As the system moves toward a more value-based, fee-for-value reimbursement environment, newer alignment vehicles, such as accountable care organizations (ACOs), clinically integrated networks (CINs), and patient-centered medical homes (PCMH) are beginning to take shape. More physician compensation models now include at least partial incentives for performance, as measured by such matters as specialty-specific quality metrics, cost efficiency metrics, meaningful use of electronic health records, and other parameters.
Starting with a review of “First Generation” physician compensation models, the authors then detail components of “Second Generation” models including:
How Value-Based Reimbursements of the future call for adjustments to the Volume-Based incentives of the past.
How to engage physicians in alignment initiatives that are favorable to both parties.
How to approach the imperative today of improved quality of care coupled with decreased costs of care.
How to be profitable in a demanding, competitive, and highly-regulated environment.
BONUS INCLUDED! Actual templates for your use:
Letters of Intent Comparative Review
Summary of Key Terms in Physician Employment Agreements
Professional Services Agreement for Specialty Services
Management Agreement
Max Reiboldt, CPA, is president/CEO of Coker Group with 44 years of total experience; the last 25 years specifically focused on healthcare. He has experienced first-hand the incredible changes of healthcare providers, which uniquely equips him to handle strategic, tactical, financial, and management issues that health systems and physicians face in today's evolving marketplace.
From his extensive work with health systems/hospitals, medical practices, and related healthcare entities, Mr. Reiboldt understands the nuances of the healthcare industry, especially in such a dynamic age. He understands healthcare organizations’ needs to maintain viability in a highly-competitive market. His experience of having “experienced everything” in the healthcare industry equips him to provide pertinent counsel to clients. Whether a transitional provider or a more cutting-edge healthcare entity, Mr. Reiboldt is uniquely qualified to work with these organizations to provide sound solutions to every day and long-range challenges.
As president/CEO, Mr. Reiboldt oversees Coker Group’s services and the general operations of the Firm. His “first love” is working with clients, providing sound financial, strategic, and tactical solutions to hospitals and health systems, medical practices, and other healthcare entities through keen analysis and problem-solving. Working with organizations of all sizes, Reiboldt engages in consulting projects nationwide.
An avid writer and speaker, Reiboldt enjoys educating healthcare leaders through books, white papers, articles, and speaking at national symposiums. His expertise encompasses physician/hospital alignment initiatives, hospital service line development, clinical integration initiatives, financial analyses (including physician compensation plans), mergers and acquisitions, hospital and practice strategic planning, ancillary services development, PHO/IPA/MSO/CIN development, appraisals, and “accountable care era” consultation. As the industry moves to adapting to the many changes in response to healthcare reform, including the entire “volume-to-value” paradigm, he leads Coker Group’s efforts in this arena.
Justin Chamblee, MAcc, CPA, is a senior vice president and director of operations at Coker Group. As an executive healthcare consultant and certified public accountant, he provides strategic and financial counsel to healthcare organizations, physician practices, and healthcare attorneys throughout the country, dealing primarily with physician compensation and hospital-physician transactions. His work in physician compensation involves strategy, by assisting healthcare organizations to restructure their compensation arrangements to ensure they are consistent with the market on a macro and micro basis. Chamblee’s work also involves compensation valuation, by helping healthcare organizations ensure that their financial arrangements comply with the requirements of fair market value and commercial reasonableness. Other areas of expertise include contract negotiations, sale/acquisition negotiations, strategic planning and business plan development, and other areas of finance.
As a recognized thought leader, Chamblee frequently presents at national conferences where physician leaders, healthcare legal counsel, and health system administrators gather to gain knowledge in the areas of physician compensation and hospital-physician integration. He has also authored several books and professional publications in collaboration with Greenbranch Publishing, Healthcare Financial Management Association, the American Medical Association, and HealthLeaders Media.
In addition to his consulting role, Mr. Chamblee is Coker’s director of operations, directing the day-to-day functioning of the company.
He has a BBA in Accounting and a Master’s in Accounting from Abilene Christian University, licensed as a Certified Public Accountant in the State of Texas, and a member of the American Institute of Certified Public Accountants. Additionally, he has completed extensive training through the Harvard Business School Leadership program.
Ellis M. (“Mac”) Knight, MD, MBA, FACP, FACHE, FHM, is senior vice president and chief medical officer of Coker Group. With over 30 years in the healthcare arena, he has developed significant experience and knowledge in this industry.
Before joining Coker, Dr. Knight served as the chief physician and clinical integration officer for Palmetto Health in Columbia, South Carolina. There, he oversaw Palmetto Health’s employed physician network and helped to develop and manage their clinical integration program, The Palmetto Health Quality Collaborative. Earlier, he was Palmetto Health Richland's vice president for medical affairs.
Dr. Knight graduated from Stanford University with a Bachelor of Arts degree in Human Biology and received his doctor of medicine degree, cum laude, from the University of Oregon Health Science Center's School of Medicine. He earned a Master of Business Administration from the University of Massachusetts at Amherst. Mac holds fellowships in the American College of Physicians, the Society of Hospital Medicine, and the American College of Healthcare Executives.
Dr. Knight oversees Coker Group’s hospital strategy and operations services and is Coker Group’s chief medical officer. He has a particular interest and expertise in population health management, clinical care process design, cost accounting and hospital-physician integration.