1. Building a Culture for Successful Physician Preference Savings
Presented to AHMMA
February 1, 2011

2. Objectives:
Discuss four approaches to physician preference savings and the varying degrees of alignment needed for each approach
Identify the barriers to physician alignment
Outline critical factors for building a supportive culture

3. Approaches to Physician Preference Savings
Pricing
Working with the vendor to obtain good pricing on the products physicians use
Standardization
Working with physicians to narrow the field of vendors to obtain better pricing
Utilization
Working with physicians to ensure the right product/service is being utilized at the right time based on the need of the patient (i.e. cost per case)
Care Management
Working with physicians to develop protocols for the care of patients with similar conditions/circumstances

4. Physician Alignment Needs
Pricing
Standardization
Utilization
Care Management

5. Barriers to Physician Alignment
Lack of support from Administration and/or Physician leaders Lack of trust Lack of awareness or understanding Inconsistent or poorly defined process History of failed attempts Failure to recognize value of alignment Lack of incentives Poor communication

6. Five Critical Factors for Building a Supportive Culture
Executive Support
Accountability
Physician Champion
Process
Communication

7. Communication
“The single biggest problem with communication is the illusion that it has taken place.” – George Bernard Shaw
Communication
Messenger
Message
Receiver(s)
Interpretation
Feedback

8. Vital Communication Points
Meet with physicians to understand the purpose of the product/service and their needs as it relates to product or service. Determine the type of contracting approach(es) that are feasible for this initiative—validate this with physicians. Enlist the physician’s help in designing a contracting strategy. Share the results of the RFP with the physicians and ask for their assistance in working with vendors. Enlist support of involved physicians in implementation. Report compliance with contract(s) on a regular basis and ask for their suggestions if commitments are not being met.
Physicians will likely speak to patient outcomes and safety, perceptions of patient interests, their own experience and comfort level with the product or service, the support provided by the supplier, and their medical training--not the cost of the product or service, or how difficult it is to procure.

9. Communication Tips
You cannot over communicate Use various methods of communication Use language the physician understands Provide an avenue for feedback during the entire process

10. Consistent & Transparent Process
Accountability
Rigor
Evaluation
Application
Analysis
Includes:
Communication
Product research
Product evaluation
Analysis
Implementation
Accountability
Application
Trust & Credibility

11. Ways to Build Trust
Shared experiences over time, Multiple instances of follow-through and credibility, In-depth understanding of unique member attributes, Get to know each other, Encourage empathy and understanding and Discourage unfair and inaccurate behavioral attributions. The FIVE Dysfunctions of a Team, A Leadership Fable; by Patrick Lencioni, 2002

12. Excellent Communication Skills
Physician Champion
Champions are an important success factor for your process and initiatives
Respected connector
Subject Matter Expert
Positive Attitude
Excellent Communication Skills
Open to change
Data Oriented

13. Accountability
Economic Credentialing:
During the recruiting process
During annual evaluations (physician profiling)
Physician Incentives

14. Ways to gain/keep executive support:
Educate/Inform Executives about your process
Frequently relate the value the process is adding to the organization
Keep executives updated on initiatives in process and any potential barriers
Explicitly state the support/assistance you need to be successful
Channel difficult and politically charged initiatives through the executives before beginning your process
Even with the four critical factors discussed thus far, the lack of executive support will lead to failure.

15. Carol Pennington, RN, BSN, MBA – cpenning@vha.com