Biomedical subjects

M Benoff

Publications and source records attributed to M Benoff.

6 recordsLinked to original sources

PubMed2001

Creating sustainable physician-IDS relationships.

IDSs that have faced financial difficulties as a result of owning physician practices need to assess whether employing physicians remains the best way to maintain effective relationships with the physicians. IDSs should evaluate each owned physician practice individually, asking a series of specific questions. First the IDSs should assess the value of the physician practice to the organization to determine whether a future relationship is desirable. If so, the IDS should determine whether the relationship needs to be formally established. If the relationship is likely to remain productive whether or not it is formal, the IDS should consider divesting the practice. If, however, a formal business relationship is required, the IDS needs to decide whether employment is preferable to an alternative approach, such as involving physicians in joint ventures or equity relationships.

Cooperative Behavior↗

PubMed2000

IDSs reconsider the viability of risk contracting.

As financial success with risk contracting continues to elude many IDSs, some of these organizations have started questioning their overall mission as risk-bearing entities. To determine whether to continue to assume risk, an IDS should consider its market environment, the commitment of its provider constituents to the organization, its core competencies, the likelihood of success with risk contracting, and alternatives. To determine its future course, the IDS should engage in a strategic-planning process that includes all IDS stakeholders. Such a process can help build consensus regarding the IDS's market characteristics and benefits of IDS membership; determine the IDS's appropriate roles, services, and functions; and evaluate resources required to pursue the desired strategy. The process should include planning for various possible future scenarios, and results should be communicated to all IDS provider constituents.

Catchment Area, Health↗

PubMed1999

How IDSs can make their risk contracts more profitable.

To understand the causes of financial losses associated with risk arrangements, and eliminate those deficits, integrated delivery systems (IDSs) need to be able to perform detailed analyses on all aspects of their utilization data. Evaluations of utilization should begin with a traditional variance analysis to pinpoint areas where costs are higher than anticipated. Then, a series of increasingly specific analyses should be performed on utilization data within those areas. Often, losses may be attributable to the inability of primary care physicians to serve as effective patient care managers. IDSs, therefore, should compare the practices of their primary care physicians and share results in a way that highlights each physician's performance while ensuring physician anonymity. IDSs should take steps to reduce future losses by providing physicians and utilization management staff with information that will help them control costs, developing a performance-improvement plan for primary care physicians, and implementing payment incentives for physicians.

Benchmarking↗

PubMed1998

Improving the financial performance of IDS-owned physician practices.

Although physician practices acquired by integrated delivery systems (IDSs) have tended to show financial losses, these practices still offer IDSs considerable overall benefits, such as expanded market share and greater coordination of care. IDSs should not necessarily avoid acquiring practices. However, it is essential that IDSs take steps to improve the financial performance of acquired practices.

Delivery of Health Care, Integrated↗

PubMed1998

Negotiating roadblocks to IDS-physician equity joint ventures.

Integrated delivery systems (IDSs) may find that forming an equity joint venture relationship with a physician group practice is the best way to integrate physicians into their networks. IDSs have a choice between two basic equity structures: affiliated group practice, in which a management services organization (MSO) handles all practice management infrastructure and the physician group is a physician-only organization; and integrated group practice, in which the physician group encompasses both the physician practice and the administrative infrastructure. The choice of equity structure and how it should be implemented hinge on several legal issues, including the existence of a corporate-practice-of-medicine statute in the IDS's state, compliance with the Federal antikickback statute and Stark laws, and various issues regarding the IDS's tax-exempt status. IDSs also should consider pragmatic issues, particularly those associated with aligning the economic incentives of the two partners.

Delivery of Health Care, Integrated↗

PubMed1997

Risk sharing in an integrated delivery system.

Development of an effective risk-sharing plan within an integrated delivery system (IDS) involves a complex decision-making process, in which the IDS should carefully assess its options to determine which will best suit its needs. In general, an IDS needs to consider four basic issues: how centralized the financial control of the risk-sharing plan should be; how the plan should be structured (eg, the number and size of budgets, interim provider payment, and the method for allocating surpluses and deficits to provider groups and individual providers); what risk-sharing strategies should be pursued; and how to avoid potentially catastrophic risk.

Budgets↗