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H C Urschel1

  • 1University of Texas Southwestern Medical School, Dallas, USA.

The Annals of Thoracic Surgery
|November 1, 1995
PubMed
Summary

This study outlines a strategic plan for medical practices to navigate the managed care environment. It emphasizes both short-term relationship building and long-term strategies to regain market position and reinvest profits into patient care.

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Area of Science:

  • Healthcare Management
  • Medical Practice Strategy

Background:

  • The current managed care environment necessitates a reassessment of medical practice operations.
  • Practices face challenges due to contract exclusions and the need to adapt to evolving healthcare economics.

Purpose of the Study:

  • To propose a strategic framework for medical practices to restructure and thrive within the managed care landscape.
  • To outline both transitional short-term actions and a long-range plan for practice sustainability and growth.

Main Methods:

  • Short-term actions include developing inter-specialty relationships, adopting a collaborative approach ('love our enemy' philosophy), and establishing competitive organizational units.
  • Internal practice reassessment focusing on unique skills, inadequacies, competition, and performance through outcome studies.
  • Long-term strategy involves developing direct insurance coverage with patients to eliminate intermediaries and reinvest profits.

Main Results:

  • Strategic restructuring and reassessment are crucial for regaining market position lost through contract exclusions.
  • Developing collaborative relationships and competitive structures are key short-term objectives.
  • Eliminating the middleman in insurance and reinvesting profits directly into patient care, research, and education is the ultimate long-term goal.

Conclusions:

  • Control over payment mechanisms directly influences the quality and delivery of medical care.
  • A dual approach of immediate operational adjustments and long-term strategic planning is essential for practice viability.
  • Reforming insurance coverage models can lead to enhanced patient care and professional development.

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