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Related Experiment Videos

Physician efficiency and reimbursement: a case study.

L E Cantrell, J A Flick

    Hospital & Health Services Administration
    |October 7, 1986
    PubMed
    Summary
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    Hospitals can improve reimbursement efficiency by implementing physician economic efficiency criteria for reappointment. This system places all doctors at individual financial risk, motivating practice pattern changes for better hospital performance.

    Area of Science:

    • Healthcare Management
    • Health Economics
    • Medical Staff Relations

    Background:

    • Joint ventures between hospitals and physicians are common for alliances and market access.
    • Existing models fail to directly involve entire medical staffs or motivate practice pattern changes for hospital reimbursement.
    • A gap exists in systems that align physician practice with hospital financial performance.

    Purpose of the Study:

    • To describe a novel system for improving hospital reimbursement efficiency.
    • To evaluate the effectiveness of physician economic efficiency criteria in medical staff reappointment.
    • To explore a method for individually engaging physicians with hospital financial outcomes.

    Main Methods:

    • Implementation of a physician economic efficiency criteria system for medical staff reappointment.

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  • Linking individual physician reappointment decisions to hospital reimbursement performance.
  • Placing all physicians at individual financial risk for hospital reimbursement outcomes.

    • Main Results:

    • The economic efficiency program has proven to be a remarkably effective tool for driving change.
    • Physician participation and motivation to alter practice patterns increased.
    • The system successfully aligned physician behavior with hospital financial goals.

    Conclusions:

    • Physician economic efficiency criteria in reappointment decisions can significantly improve hospital reimbursement.
    • This controversial yet effective model individually engages physicians with financial performance.
    • Hospitals can leverage such systems to motivate practice pattern changes and enhance financial outcomes.