Coffee with Coker

Justin Chamblee, Jon Morris and Stephen Ross join Mark for a round table discussion on physician compensation strategies. Mark moderates the discussion as Justin, Jon and Stephen outline current trends in designing and managing physician compensation plans, the strategic elements of physician compensation plan design, and the impact of value-based reimbursement on physician compensation and fair market value/commercially reasonable analyses.

About the Panelists

• Justin frequently presents at national conferences where physician leaders, healthcare legal counsel, and health system administrators gather to gain knowledge in the areas of physician compensation and hospital-physician integration. He is a recognized thought leader and subject matter expert on physician compensation.
• Jon currently focuses his practice on designing and implementing system-wide physician compensation plans that help organizations navigate the shift from volume to value.
• Stephen specializes in assisting healthcare organizations in the areas of hospital-physician alignment transactions, compensation valuation work, compensation plan redesign, strategic business planning and operational/financial performance improvement.

Extras

White Paper: Using Patient Panel as a Principle Element in Primary Care Physician Compensation

Fair Market Value: Assessing Compensation Arrangements in the Healthcare Industry

Follow Justin on Twitter

Connect with Justin on LinkedIn

Connect with Jon on LinkedIn

Connect with Stephen on LinkedIn

Contact Information

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We welcome all feedback from our listeners. Please submit questions on any of the topics we discuss or questions about issues in which you have an interest. You can also provide recommendations on topics for future episodes.

• Email us: [email protected]
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• Connect with us on LinkedIn: Coker Group Company Page

Max Reiboldt and Michael Barry join Mark to discuss the Top 10 Lessons Learned from First-to-Second Generation Transactions. Max oversees Coker Group's services and the general operations of the firm, and provides sound financial, strategic and tactical solutions to hospitals, medical practices, health systems, and other healthcare entities through keen analysis and problem solving. Michael is a partner in the Corporate Practice and the Healthcare Practice at Arnall Golden Gregory, LLP and focuses his practice on health care transactional and regulatory law – specifically for hospital, health systems and other institutional providers.

Episode Synopsis

Mark, Max and Michael discuss transitioning from a first-to-second generation transaction and industry trends affecting hospital-physician transactions. Throughout their discussion, they touch-on the top 10 lessons they have learned from these types of alignment initiatives.

Top 10 Lessons Learned from First-to-Second Generation Transactions

1. Physician market share does not mean success, so health systems have become more selective relative to transactions. (PSAs are much more popular now than 3 years ago.)
2. Incurring losses in physician transactions may not be offset by downstream revenue (increased site-neutral payments).
3. Ensure organization's productivity and revenue goals are being met. (Fee-For-Service still prevails.)
4. Consider infrastructure required to support non-productivity incentives. (Fee-For-Value payments must exist to require such.)
5. Gradually begin tapering off productivity goals and replace with alternative incentives. (Mirror reimbursement trends.)
6. Tie new incentives to organizational goals, such as cost-savings, quality, etc. and prepare to respond to MACRA/MIPS requirements.
7. Begin tying incentives to reimbursement changes, such as shared savings and/or the quality/CPIA/ACI metrics being measured for MIPS.
8. Leverage newly prioritized metrics to reap additional reimbursement incentives (i.e., commercial or MIPS increases).
9. Continually reassess compensation structures in light of regulatory and industry trends.
10. Payment reform is here and real (MACRA); healthcare providers are unable to ignore the value-based reimbursement world.

Extras

Second Generation Compensation Plans - Is this Alignment Armageddon? Part 1

Second Generation Compensation Plans - Is this Alignment Armageddon? Part 2

Contact Michal Barry (Arnall Golden Gregory)

Follow Max on Twitter

Connect with Max on LinkedIn

Contact Information

Subscribe to our feed in Apple Podcasts, Google Play, Spotify or your preferred podcast provider. Like what you hear? Leave a review! Not there? Let us know!

We welcome all feedback from our listeners. Please submit questions on any of the topics we discuss or questions about issues in which you have an interest. You can also provide recommendations on topics for future episodes.

• Email us: [email protected]
• Follow us on Twitter: @cokergroup
• Connect with us on LinkedIn: Coker Group Company Page

Jeffery Daigrepont joins Mark to discuss the fatal mistakes of healthcare IT vendor contracting. Jeffery speaks often on this subject and is intimately familiar with the potential pitfalls of electronic health record vendor contracts.

Episode Synopsis

Jeffery provides his insight on the top five mistakes committed during vendor contract negotiations and what to avoid, even if you are already under contract with a vendor. Jeffery walks Mark through the common inclusions within contracts that can be removed or modified.

Extras

White Paper: Five Fatal Healthcare IT Decisions to Avoid

Understanding and Negotiating IT Vendor Contracts

Follow Jeffery on Twitter

Connect with Jeffery on LinkedIn

Contact Information

Subscribe to our feed in Apple Podcasts, Google Play, Spotify or your preferred podcast provider. Like what you hear? Leave a review! Not there? Let us know!

We welcome all feedback from our listeners. Please submit questions on any of the topics we discuss or questions about issues in which you have an interest. You can also provide recommendations on topics for future episodes.

• Email us: [email protected]
• Follow us on Twitter: https://twitter.com/cokergroup
• Connect with us on LinkedIn: https://www.linkedin.com/company/coker-group/

Aimee Greeter and Taylor Harrison join Mark to discuss Five New Approaches to Maximize Physician Engagement. Aimee and Taylor specialize in hospital/physician alignment, accountable care responsiveness, hospital service line development, clinical integration initiatives, strategic planning, mergers and collaborations, operational issues, and financial management.

Episode Synopsis

Mark, Aimee and Taylor discuss strategies to better engage with healthcare providers and maximize their engagement to drive change for an organization. Throughout their discussion, they walk through strategies to assess physician engagement and drive change within an organization.

Three Primary Drivers of Change

1. Impact of Reimbursement Changes
2. Authority of Decisions
3. Relationships with Other Providers and Organizations

Five Approaches to Increase Physician Engagement

1. Increase transparency and create a collective mission/vision.
   1. Ask questions of providers and ensure that any grievances are quickly addressed.
   2. Use multiple forms of communication, multiple times.
   3. Manage physicians by walking around—listen and learn.
   4. Determine the motivation behind physicians and work to create incentives that match.
   5. Develop a philosophy of mutual benefit and shared vision.
   6. Strive to be extremely transparent from upper management down.
   7. Solicit meaningful physician input early and often, and then act on it.
   8. Engage physicians in balancing business and clinical priorities.
   9. Set realistic goals together and go for early wins.
2. Nurture physician leaders.
   1. Identify, mentor, and educate physician leaders.
   2. Invest in physician leaders.
   3. Reward physicians in ways they value.
   4. Attend a leadership conference together or hire a coach to complete leadership training on-site.
   5. Get to know physicians on a personal level—meet one-on-one.
3. Capture and share data.
   1. Implement processes that help determine what data is to be collected and how.
   2. Use data as the platform for discussions on improving care and lowering costs.
   3. Foster trusting relationships by sharing data frequently and broadly.
   4. Encourage physicians to use data to make decisions.
4. Develop metrics and hold physicians accountable.
   1. Ensure that physicians are a part of creating the metrics (quality, cost, patient satisfaction, etc.).
   2. Make metrics specific to each individual specialty and/or sub-specialty (depending upon the size of the organization).
   3. Utilize physicians to meet with colleagues that fail to meet these measures.
   4. Tie certain incentives to these metrics (i.e. compensation, service line improvement initiatives, medical directorships, etc.)
5. Work toward clinical integration.
   1. Regardless of the format in which you pursue clinical integration, establish a collaborative method of delivering care.
   2. Involve as many physicians as possible (employed, community, etc.).
   3. Determine a method that best meets your needs – not all organizations should immediately pursue an ACO or CIN.

Extras

White Paper on Maximizing Physician Engagement (includes survey and case studies referenced)

Follow Aimee on Twitter

Connect with Aimee on LinkedIn

Connect with Taylor on LinkedIn

Contact Information

Subscribe to our feed in Apple Podcasts, Google Play, Spotify or your preferred podcast provider. Like what you hear? Leave a review! Not there? Let us know!

We welcome all feedback from our listeners. Please submit questions on any of the topics we discuss or questions about issues in which you have an interest. You can also provide recommendations on topics for future episodes.

• Email us: [email protected]
• Follow us on Twitter: https://twitter.com/cokergroup
• Connect with us on LinkedIn: https://www.linkedin.com/company/coker-group/

Jeffery Daigrepont joins Mark to discuss the healthcare IT market and provide his thoughts on the current and future trends. Jeffery specializes in healthcare automation, IT system integration, operations, and deployment of enterprise information systems for large integrated delivery networks.

Episode Synopsis

Mark and Jeffery look at the evolution of the healthcare IT market over the past two decades and discuss what is on the horizon for healthcare technology. Throughout their discussion, they walk through what has driven changes in the healthcare IT realm, current trends, and how best to prepare for the future.

They discuss everything from legacy electronic health records to cloud-based technology and the use of artificial intelligence in the healthcare delivery process. Mark and Jeffery provide insight on how to adapt to the ever-changing world of healthcare technology.

Extras

Learn More about Healthcare IT Consulting

Healthcare Cybersecurity Threats and Trends for 2018

Top Health IT Trends and Innovations

Follow Jeffery on Twitter

Connect with Jeffery on LinkedIn

Contact Information

Subscribe to our feed in Apple Podcasts, Google Play, or your preferred podcast provider. Like what you hear? Leave a review! Not there? Let us know!

We welcome all feedback from our listeners. Please submit questions on any of the topics we discuss or questions about issues in which you have an interest. You can also provide recommendations on topics for future episodes.

• Email us: [email protected]
• Follow us on Twitter: https://twitter.com/cokergroup
• Connect with us on LinkedIn: https://www.linkedin.com/company/coker-group/

Justin Chamblee and Jon Morris join Mark to discuss the recent release of the 2018 MGMA provider compensation market data and Coker's observations of market data trends. Coker has been observing the data for the past five-to-ten years, noticing the increases that have been occurring.

Episode Synopsis

Justin and Jon discuss the reasons behind the continual upward shift of the market median despite an industry-wide decline in reimbursement. On May 16, 2018, MGMA released their annual Provider Compensation and Productivity Survey Report and Coker noticed (again) an upward trend in the reported total cash compensation to wRVU ratio.

Justin, Jon and Mark provide insight as to the cause of the continual increases year after year and what these increases mean for the future.

Figures

Figure 1: Total Cash Compensation to wRVU Ratio 10-Year Trend (Table)

Figure 2: Total Cash Compensation to wRVU Ratio 10-Year Trend (Chart)

Extras

White Paper on The Upward Shift of the Median (2014)

The Myth of the Median

Contact Information

Subscribe to our feed in Apple Podcasts, Google Play, or your preferred podcast provider. Like what you hear? Leave a review!

Not there? Let us know! We welcome all feedback from our listeners. Please submit questions on any of the topics we discuss or questions about issues in which you have an interest. You can also provide recommendations on topics for future episodes.

• Email us: [email protected]
• Follow us on Twitter: https://twitter.com/cokergroup
• Connect with us on LinkedIn: https://www.linkedin.com/company/coker-group/

Michele Madison from Morris, Manning & Martin, LLP, joins Mark to discuss how to create long-term value from transactions through effective post-merger integration. Michele is highly experienced in managing legal issues arising in hospitals, physician offices, or integrated health systems.

Episode Synopsis

Mark and Michele recently presented at the American Health Lawyers Association Healthcare Transactions conference on the topic of post-merger integration. Throughout their discussion, they walk through why it is critical to consider the goal of effective integration after a merger throughout the entire transaction process.

The foundation is to first define what we mean by "makes a transaction work"; that is, a deal that results in long-term value creation for all stakeholders. Measuring the true success of a transaction requires a look far beyond the initial perspective of fit and financial returns, focusing instead on whether the affiliation resulted in compelling value realized over an extended period.

Topics covered in this episode include strategic validation, due diligence, regulatory risks, deal structure, integration structure, and implementation. Mark and Michele offer their advice on how to structure deals while considering the long-term effects of integration.

Extras

Michele Madison - Martin, Manning & Morris, LLP

White Paper on Effective Post Merger Integration

Contact Information

Subscribe to our feed in Apple Podcasts, Google Play, or your preferred podcast provider. Like what you hear? Leave a review!

Not there? Let us know! We welcome all feedback from our listeners. Please submit questions on any of the topics we discuss or questions about issues in which you have an interest. You can also provide recommendations on topics for future episodes.

• Email us: [email protected]
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Jeff Gorke joins Mark to discuss operational issues and challenges medical practices face in the physician services realm. Jeff has expertise in optimizing the strategic and operational aspects of outpatient care to enhance processes and programs, drive efficiencies, and improve profitability.

Episode Synopsis

Mark and Jeff explore the greatest challenges hospitals and physicians face today and the importance of a strong relationship between the physicians and administration. As providers of healthcare, physicians need a seat at the table to help change the delivery of care.

The focus of healthcare is shifting from volume to value, and many physicians are struggling to remain in private practice. Small independent groups will continue to face challenges as costs rise. Further, we have already seen a significant uptick in hospital employment over the last 10 years.

Another factor impacting medical practices and hospitals alike is technology. Telehealth is gaining popularity, and, love them or hate them, electronic medical records (EMRs) are essential to the modern medical practice.

Mark and Jeff provide their insight on these topics and other operational issues in employed and private medical practices.

Extras

AMA Study Reveals Practice Owners No longer Physician Majority

White Paper on Revenue Cycle Turnaround

White Paper on Employed Physician Turnaround

Contact Information

Subscribe to our feed in Apple Podcasts, Google Play, or your preferred podcast provider. Like what you hear? Leave a review!

Not there? Let us know! We welcome all feedback from our listeners. Please submit questions on any of the topics we discuss or questions about issues in which you have an interest. You can also provide recommendations on topics for future episodes.

• Email us: [email protected]
• Follow us on Twitter: https://twitter.com/cokergroup
• Connect with us on LinkedIn: https://www.linkedin.com/company/coker-group/

Dr. Ellis "Mac" Knight joins Mark to discuss value-based healthcare and its impact on the healthcare industry. They cover financing as a driving force in the healthcare landscape and why it continues to become more complex with the shift from pay for service to value-based care.

Episode Synopsis

With budgetary pressures on Medicare and Medicaid, pay for performance and federal expectations for investment in technology without regard to costs, executives must continuously monitor the financing landscape. The most significant factor in healthcare reimbursement today is the industry-wide shift to value-based care.

So, what is value-based care? One of the more common buzz phrases in the healthcare industry, value-based care, is a shift in focus. For the past two decades, healthcare providers have focused their efforts on the volume of services they are providing, not on the quality of services they are delivering. The reason is simple: physicians were paid only for the volume of professional services.

In 2015, the Medicare Access and CHIP Reauthorization Act (MACRA) was passed and ushered in a dramatic change in the way CMS will pay healthcare professionals. MACRA consolidated multiple pay-for-performance initiatives (PQRS, VPM, and MU) into two quality payment programs (QPPs), the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs).

Dr. Knight and Mark provide their views on the move toward value-based reimbursement and the reality of healthcare for the past 15 years.

Extras

MACRA, what IS it?

White Paper on Value-Based Reimbursement

White Paper on MACRA

Connect with Dr. Knight on LinkedIn

Follow Dr. Knight on Twitter

Contact Information

Subscribe to our feed in Apple Podcasts, Google Play, or your preferred podcast provider. Like what you hear? Leave a review!

Not there? Let us know! We welcome all feedback from our listeners. Please submit questions on any of the topics we discuss or questions about issues in which you have an interest. You can also provide recommendations on topics for future episodes.

• Email us: [email protected]
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Welcome to the inaugural episode of Coffee with Coker, a healthcare business podcast published by Coker Group. In this episode, we will introduce the Coker team and lay the groundwork for the podcast moving forward.

The Coker Team

• Mark Reiboldt, Senior Vice President and Director of Strategy -- Lead Host
• Jessica Combs, Senior Associate and Social Media Manager -- Producer/Guest Host

Episode Synopsis

Coker Group is a national healthcare consulting firm with over 30 years of experience in the industry. We advise healthcare organizations and physicians on all business matters including hospital and practice operations, financial advisory, hospital and health system strategic initiatives, and healthcare technology.

Our discussions each episode will focus on current events, market trends, and significant developments that impact the healthcare industry. Our goal is to inform our audience on the present-day and upcoming developments and best practices for healthcare professionals.

The main episodes of the podcast will be released twice per month, with shorter "espresso-shot" episodes released periodically to address hot topics. Each episode will feature a guest host who will discuss his or her area of expertise with Mark.

Contact Information

Subscribe to our feed in Apple Podcasts, Google Play, or your preferred podcast provider. Like what you hear? Leave a review!

Not there? Let us know! We welcome all feedback from our listeners. Please submit questions on any of the topics we discuss or questions about issues in which you have an interest. You can also provide recommendations on topics for future episodes.

• Email us: [email protected]
• Follow us on Twitter: https://twitter.com/cokergroup
• Connect with us on LinkedIn: https://www.linkedin.com/company/coker-group/