Physician Integration: The SSM Vision, Getting It Done, Chapter 16

Introduction

Physicians are trained for individual excellence, whereas hospitals are complex organizations that tend to view care as a team activity. Ultimately, physicians and hospitals have the same goal in mind—to provide high-quality, safe care to patients. SSM Health Care, a 4,006-bed Catholic health system based in St. Louis, Missouri, works collaboratively with its physicians because it realizes that, while individual competence is critical, so are coordination and communication among all members of a care team. SSM sees physician integration as an opportunity for improvement.


 

Case Presentation

SSM Health Care has grappled with the evolving nature of its relationships with physicians. It has tried putting physicians on the payroll and joint ventures, partnering with physicians to operate imaging, ambulatory surgery, and diagnostic centers. It has been successful weaving together several integration models.

For SSM, co-management—a mutually beneficial arrangement in which physicians and hospitals work collaboratively to improve operations and clinical quality—is proving successful. While relations between physicians and SSM have often been mutually beneficial, SSM seeks to improve them. SSM’s culture asks how the organization can do things better (continuous quality improvement), so it always sees room for growth. For SSM to achieve the levels of success that benefit its patients, exceptional physician relations are critical.

St. Anthony Hospital Oklahoma faced a challenge with its heart and vascular service line. The hospital was looking for a model to align 14 independent cardiologists plus cardiovascular and vascular surgeons, many of whom were being wooed by the physician-owned heart hospital in town.

The St. Anthony Cardiovascular Services Institute was formed October 2007. Through the institute, the hospital and its physicians work together to improve heart and vascular care. Twenty-five percent of the co-managed institute is owned by the hospital, and 75 percent is owned by physicians.

As a result of improved hospital-physician collaboration, St. Anthony saw compliance with Centers for Medicare and Medicaid Services core measures jump between 2007 and 2009: compliance with guidelines for acute myocardial infarction rose from 92.5 percent to 99.7 percent and congestive heart failure from 79.8 percent to 98.9 percent. It also reduced its cost per case by 20 percent. Five new cardiology outreach clinics opened in 2008 and 2009, increasing patients’ access to care. In 2010, SSM Health Care of Oklahoma earned the Oklahoma Quality Award for Excellence.

Conclusion

Here are some of the  lessons SSM has learned over the past five years:

  • One size doesn’t fit all when working on physicians integration projects
  • We must recruit strong, collaborative physicians and hospital leaders to build trusting relationships
  • We must communicate and respect the lines of authority and goals of our partnerships
  • We must stress accountability by all caregivers
  • Patients come first, so we must check our egos at the door

As always, I welcome your input to improve healthcare collaboration and get it done.

Kenneth H. Cohn

© 2011, all rights reserved

Disclosure: I have not received any compensation for writing this content.

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