Group collaboration: Three pillars support practice success

As the health care market matures, consolidation will occur throughout the system, including within medical groups, says Steven M. Berkowitz, MD.

“It is a natural phenomenon reflecting the maturation of the health care industry," said Dr. Berkowitz, founder and president of SMB Health Consulting in Austin, TX.

"You have already done the right thing if you have come together as a group. Now the challenge is to make the group better. The goal is to achieve true management of the urologic burden of a community," he told Urology Times.

Dr. Berkowitz, who presented data and his own views on group collaboration and subspecialization Friday at the Large Urology Group Practice Association annual meeting in Chicago, told Urology Times that there are three pillars supporting success in today's evolving health care system-clinical integration, financial integration, and structural integration-all of which involve a shared responsibility in creating and governing a successful working infrastructure.

He explained that clinical integration meant embracing data transparency, implementing best practices where they exist, and excelling at pay for performance.

"We need to embrace the concept of transparency in terms of quality, outcomes, patient satisfaction, and cost effectiveness," Dr. Berkowitz said.

Pay for performance, which once lay completely within the purview of hospitals, is now becoming an aspect of group and solo practice medicine, he said. Groups have to excel at pay for performance to succeed.

Financial integration consists of managing costs and risk products, Dr. Berkowitz explained.

"There is going to be more of an emphasis on cost control than there has ever been in solo practices, in group practices, and in hospitals. By risk, I mean Medicare, risk products, capitations, bundled payments, and other such products. It is going to vary from market to market, from state to state, but there is some degree of risk in every market," he said.

Structural integration is the third pillar supporting a successful group practice.

"This means a group must have good governance. It must work toward ideal practice management. Not every doctor in a group can practice the same kind of urology. There must be specialization, which is a strength because it circles back to managing the patient population," said Dr. Berkowitz.

A shared infrastructure and governance requires members to think as a group, ensure all members are fairly compensated, and each has a subspecialty that contributes to the group's performance and ability to manage its population.

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