Health Care in California: Implementing a Medical Foundation Model
October 10, 2010
Posted by chcablogadmin in : Manpower & Workforce
Is the proposal of the Hospital Association of Southern California to create a joint medical foundation for its members a sign of the growing alignment between doctors and hospitals? Will this trend be accelerated by health care reform? The new law encourages formation of health organizations that can coordinate overall patient care as a means of improving outcomes and efficiency. But critics of the mergers say integrated health systems may be able to drive up prices because of their leverage in negotiations with private insurers. Kim Cripe gives us an insider’s perspective on the medical foundation model. — Don
by Kimberly C. Cripe, President and CEO, Children’s Hospital of Orange County
Kim Cripe
Like many states across the country, California is suffering from a shortage of pediatric subspecialty physicians. Factors unique to the state include high cost of living, debt burden of new graduates and comparatively poor reimbursement rates. Faced with this physician shortage, Children’s Hospital of Orange County (CHOC) is pursuing the California medical foundation model to help fulfill subspecialty recruitment needs as well as to improve relationships and provide stability to existing medical staff.
The foundation model was developed in response to California’s corporate practice of medicine statute that prohibits hospitals from employing physicians. The foundation does not employ physicians; instead, it contracts with independent physicians or medical groups to provide professional services to foundation patients. This model is required to provide teaching and research services. Another potential benefit may be functioning on some level as a group purchasing organization. While the foundation model is specific to California law, similar models may be appropriate in other states where laws restrict the employment of physicians.
By implementing the foundation model at CHOC, we anticipate it will:
Create a more stable and reliable physician organization
As our nation’s health care delivery model continues to focus on providing coordinated care for patients and managing costs, we believe formal arrangements between physicians and hospitals, like the foundation, will enable all involved to work more collaboratively on systems and structures to reach this goal.
Attract physician recruits and allow for joint contracting
The critical goal is to develop strong physician relations and loyalties that will allow us to provide the best and most comprehensive care for our patients. By contracting for physician services through a foundation, we are able to ensure reasonable compensation and a stable working environment for our physician partners.
Integrate and improve quality of care
Ultimately, we believe the best care for our patients can be achieved when hospitals and physicians have an organizational structure that allows them to jointly focus on delivering the best care to our shared patient population.
We believe this is a very sound model for CHOC. I’m curious what your thoughts are. Have you seen similar models at play in your markets? I’d appreciate your comments.
Comments»
We do not have a foundation model in place but do contract with medical subspecialists who are independent contractors for exclusive services. The limitation in our model is that it is incremental. Each specialty is individually under contract. It is up to us to assure consistency and alignment. Whether you elect employment, foundation or limited service contracting the obvious key involves alignment of values and goals. If you’ve got that I think almost any model has a chance for success. If alignment is missing the opportunity for under achievement is great. Good luck with the model. I’ll be interested in hearing about results.