Note: This post is a bit different from the content we normally share. We are excited about the possibilities shared below and hope you find the post informative and helpful. Please don’t hesitate to reach out with any questions, info@barlowmccarthy.com.
The Traditional Way
Medical Staff Development Plans (MSDPs) have been around for decades. Plans first surfaced in the 1980’s and focused on physician-to-population ratios to estimate community need for physicians. The early ratios were developed by government agencies in response to concerns over looming physician shortages e.g. Graduate Medical Education National Advisory Committee (GMENAC). Academics, researchers and consulting groups soon followed with a variety of population ratios based on different approaches.
Regardless of the ratio(s) employed, the approach was basically the same: 1) apply ratio(s) to the current and projected population of a certain geographical area to estimate physician “demand” and 2) compare demand to the number of physicians practicing in the area to estimate community need by specialty. This type of analysis also served to comply with federal regulations regarding financial incentives for physicians. (see Stark II, Phase III for further details).
Recognizing that these ratio-based methods provided only a limited, one-time snapshot, more robust models began to emerge in the late 1990’s and continue to this day. While retaining the ratio approach, these Generation 2 models incorporated a number of components designed to provide a more comprehensive view of medical staff planning needs. All things considered, many Generation 2 models were successful in achieving this goal by including some or all of the following:
- Competitive position and other market dynamics affecting medical staff planning
- Physician and administrative staff interviews to collect qualitative input
- Medical staff surveys to include a broader range of input
- Medical staff age profiles to support succession planning
- Capacity measurements to assess wRVUs compared to budget or benchmarks
- Access availability measured by appointment wait times
- Alignment activities in the market to address referral and admitting activity
Time for a Change
At Barlow/McCarthy we believe the market is ready for an evolved approach to medical staff development planning. Let’s start by stating that medical staff planning needs to move from its traditional tactical position to a strategic place in the organization. There should be no doubt, the medical staff is a strategic driver for the organization and deserves the same attention and oversight as Finance, Business Development and Operations. Also, the current pandemic is not only affecting medical staff planning now, but it will most definitely have an impact into the future.
As a result of this shift in focus, we are retooling our planning process to include a name change to Strategic Medical Staff Planning or SMSP. It’s important to note that our approach is not a break with the past, but rather strives to retain what has worked previously while adding elements to meet today’s medical staff planning needs. Basically, we are proposing an evolution and not a revolution when it comes to medical staff planning. Hence the name Strategic Medical Staff Planning or SMSP.
Introducing key elements of our evolved approach:
- Remote execution of the project is a must. On-site visits have been replaced by conference calls, online meetings and even good, old email. We have retooled our process so that all project steps from start to finish can be completed remotely.
- Healthcare demand is unlikely to return to pre-COVID-19 levels in the near future. Consumer anxiety over safety concerns and economic stress will likely suppress demand. We have retooled our approach to include “what if” adjustments to population ratios to better reflect clinical activity in a post-Covid-19 environment.
- Telehealth is here to stay. Telehealth has been shown to be a highly effective way to access healthcare safely during the Covid-19 pandemic. However, a patchwork of solutions is insufficient for integrating telehealth across the care continuum and meeting increased demand moving forward. We have redesigned our interview guides and medical staff surveys to assess how well the organization is positioned in the telehealth arena and appropriate next steps to address any obstacles to offering virtual care.
- Here we go again – service line growth strategies will refocus on centers of excellence. It is unlikely that health systems will reopen underperforming care sites for some service lines. As a result, the focus will shift from “how do we provide everything” to “what should we provide to support the community and remain financially viable.” We offer the opportunity to complete a deep dive analysis on key service lines to assess their readiness for center of excellence designation.
- Advanced Practice Providers are key players in the post-Covid-19 environment. Renewed interest in the role of Advanced Practice Providers is based on several factors such as looming physician shortages, changing reimbursement models and the need for more cost-effective and efficient care delivery. We include NPs, PAs, mid-wives, etc. in our demand analysis along with both capacity and access assessments.
- Primary care competition will change in the post-Covid-19 environment. While many of the players are not new, urgent care/walk-in clinics, concierge providers, community health centers and others will use the pandemic disruption period to retool their delivery models and lock in patient relationships. We include a full assessment of these delivery models and their likely impact on competition as well as growth opportunities for the organization.
- The consumer is back in the game. Now more than ever, providers and health systems must fully understand consumer needs and preferences in today’s environment. For example, how will you inform consumers of your services including telehealth? Are patients ready for virtual care in your market? How will you collect and track patient feedback? Our approach includes an optional consumer survey that can be customized to help your organization address many of these issues in your local market.
We strongly believe that the market is ready for a more robust approach to meet today’s medical staff planning needs. To meet these challenges, medical staff planning needs to assume a strategic position in the organization. While the pandemic has accelerated the need for change, we believe the same changes would have occurred naturally over time. Our approach builds on past successes while adding new elements to enhance the planning process.
If you would like more information about Barlow/McCarthy and our Strategic Medical Staff Planning capabilities, please contact us at info@barlowmccarthy.com or by phone at 866.315.7774.