The healthcare industry continues to see a rise in the number of physician practices being acquired by hospitals and healthcare systems. This trend is influenced by: (1) new physicians entering the workforce who are focusing on maintaining a work-life balance and do not want the responsibility of managing an office setting; and (2) regulatory changes that favor establishing accountable care organizations (ACOs) and value-based payment systems.
Overseeing risk management programs for acquired physician practices can be a daunting prospect for even the most seasoned hospital risk manager. If you are a hospital risk manager who does not have a background in physician practices, it is important to become familiar with the risks associated with the practice model.
Identify the required areas of knowledge and develop resources to enhance your ability to provide effective risk management services. To be successful, you must have the support of the organization’s top leadership and the physician practice leaders, as well as a clear understanding of the scope of and expectations for what must be accomplished.
It is important to establish priorities and determine the resources needed based on the size of the physician practice and its growth potential. No two risk management departments are the same, so finding data to quantify the needed resources can be difficult.
It is important to understand the operation and environment of the practice prior to and after the acquisition so you can prepare to mitigate and manage any associated risks. Our Interactive Guide for Office Practices risk assessment tool can help you identify liability risks in an office setting. It covers the following areas:
The resources required will be determined by the scope of the physician practice risk management program. Is the program limited to loss identification and prevention, or does it include claims management as well? Is it limited to a specific type of risk management, such as clinical risk management, or does your responsibility reflect more of an enterprise risk management approach?
If hiring additional risk management staff is not an option, it is imperative that the physician practice manager assume ownership of the practice’s day-to-day risk management responsibilities. This will require you to educate the practice manager on the principles of risk management and the expectations involved—such as reviewing incident reports, performing follow-up on reported events, analyzing data to identify trends, communicating risk management information, and educating their staff.
Larger healthcare organizations may have the resources to provide a risk manager for a more hands-on approach to managing and addressing the risk management needs of multiple physician practices.
These tips can assist you in establishing the framework for a successful physician practice risk management program within a hospital-based system:
Your patient safety risk manager from The Doctors Company can help you implement strategies tailored to your needs. Contact us at 800.421.2368, extension 1243, or firstname.lastname@example.org.
The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider considering the circumstances of the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.