1. LEADERSHIP Partnering with your hospital or healthcare system Kevin W. Lutz, DPM May 19, 2012 Vice President, Surgery & Anesthesia

2. 2 “Hospitals are looking for innovative ways they can align the economic interests of their doctors.” Lani Berman, MPH, MBA VHA, Inc. 2012

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4. Trends in Healthcare

5. 5 A PricewaterhouseCoopers survey found 71% of physicians are currently aligned with hospitals on some level, from directorships to employment. OR Manager Vol 28, No Page 7

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7. 7 Physicians are employed for medical services. In return, either a full-time or part- time salary is paid by a hospital, medical foundation, provider-based clinic, faculty practice plan, or group practice. Employment In a joint venture between physicians and a service line, such as an ambulatory surgery center, the venture owns the service line and bills third-party payers for patient services. Joint Venture The hospital contracts with physicians to manage a service line wither by direct contract or through a new-entity joint venture. Comanagement Alignment models

8. 8 Under a contractual relationship, a clinician leader provides leadership and administrative oversight. Directorships, stipends, and management contracts A structured arrangement between a hospital and physicians to share savings for a service without jeopardizing quality. The arrangement meets specific criteria set by the Health and Human Service Office of Inspector General. Gainsharing A hospital and physicians collaborate to reach targets for cost and quality for a procedure or service line. The hospital shares savings by reinvesting into the service line. Program reinvestment

9. What? A MEGATREND

10. A Megatrend 10 “Physician employment is a megatrend-in most cases, it’s going to be the model” “ A driving force is bundled payment, expected to become a common model in the next few years” Ken Mack, Hospital-Physician Consultant

11. Medical Directorship 11 Most popular form of alignment Hourly rate is dependent on FMV of specialist. For a podiatrist* it is approximately $265.00 per hour. Medical Director of ______________ Directorships have a contract that contain specific language around Job Duties Hours per week Benefits

12. 12 Medical Staff Leadership

13. 13 Department Chair Department Vice-Chair Credentials Committee Medical Executive Committee Executive Committee Peer Review

14. How do you get a piece of the pie?

15. 15 Get off our island and……..

16. 16 It all begins here

17. 17 Be yourself Know your worth Build Relationships Know your limits Use your network Be professional The secret ingredients….

18. 18 What not to wear to the hospital….

19. Good luck… call anytime! Questions?