Most hospital systems that have or are developing accountable care organizations state the new structure is affecting the way they hire physicians.
Seventy-eight percent of 105 hiring executives stated they wanted physicians who were team-oriented, 68% were looking for physicians who were motivated by quality incentives, and 65% sought physicians who were technologically savvy, according to a report released Oct. 2 by the Medicus Firm, a doctor recruiter based in Dallas and Atlanta. Theyre asking for the skills in part because hospitals dont believe all their physicians have them: 58% stated between zero and half their doctor staff were a good fit for ACOs.
There are certain personality attributes and characteristics that, unless it was for a doctor leadership position, I dont think most places have really asked for before, stated Jim Stone, president of the Medicus Firm.
ACOs are becoming an increasingly common way of attempting to control costs and increase quality for patients with government or commercial insurance. According to Leavitt Partners, a consultancy based in Salt Lake City, 221 ACOs operated in 45 says as of the end of May. New ones are announced on a regular basis.
Independent practice physicians in an ACO usually are paid fees for services to participating patients and provided with the incentive of earning bonuses for meeting quality metrics or saving money on the cost of caring for a population. Employed physicians could be compensated in a similar way. In the Medicus survey, 61% stated they would use incentives based on the ACOs success as part of the formula for paying physicians, whether they were employed or affiliated. Seventy-five percent of respondents stated they were adding physicians to their ACOs as employees only.
The health systems in the survey expressed optimism about finding physicians who are flexible in who they work with and when they work. Fifty-four percent wanted physicians who are comfortable working with doctor assistants and nurse practitioners. And 41.5% were looking for physicians who are flexible with work schedules and willing to work nights and weekends and take calls at home.
Weve been looking for quite a while for physicians who would at least play well with others, stated Jonathan Swartz, MD, regional medical director of Montefiore Medical Group in New York, which works with Montefiore ACO. We really want physicians to work in a team with nurses, medical assistants and other physicians.
The Center for Medicare & Medicaid Innovation has designated Montefiore ACO as a pioneer accountable care organization.
A significant proportion 46.3% stated ACO participation would modestly increase their doctor recruitment needs, and 2.4% reported that they would grow markedly. In addition, 43.9% stated recruitment would not change and 7.3% thought the need for physicians would go down. Eighty percent stated they would need to hire more NPs and PAs.
Physician recruiters stated finding candidates is already difficult for many hospitals because of the high demand for doctors. Therefore, there is a push for physicians to participate in various types of in-house training and development. Physicians, especially ones in primary care, are in short supply, and this is expected to worsen as millions more people gain insurance under the Affordable Care Act.
An can be taught, Stone said. Technology can be taught. The capability to work together as a team sometimes that can be coached, sometimes it cannot. It is going to depend on the individual.
The survey was distributed to hiring executives at 144 hospital systems, 139 of which did not respond to questions about ACOs because none had formed one or were thinking about doing so soon.
What hospital-led ACOs want from physicians
The development of accountable care organizations, one of the key components of health system reform, has hospital executives emphasizing certain nonclinical skills. A recent survey showed that executives stated they were looking for physicians who:
68.3%: Are motivated by quality incentives
65.9%: Are technologically savvy
53.7%: Are comfortable working with doctor assistants and nurse practitioners
41.5%: Are flexible with work schedules, night hours and weekend hours
Source: Physician Recruiting and ACOs, The Medicus Firm, Oct. 2
Copyright 2012 American Medical Association. All rights reserved.
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Submited at Wednesday, October 24th, 2012 at 12:15 am on Uncategorized by madison
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