ACC CV SUMMIT: The Economics of Co-Management

Saturday, January 18, 2014

Suzette Jaskie, President & CEO for MedAxiom Consulting, opened the presentation by defining the co-management continuum as a formal relationship where physicians share in the management of all or parts of the cardiovascular service line where there is a clear definition of scope and authority, where the service line is accountable to pre-defined metrics, and those involved are compensated for time and achievement of goals.

Ms., Jaskie stated that she feels there are really only two components to co-management agreements: Management services (physician time) and Improvement services (meeting pre-determined goals). These components should then translate into payment for these services including incentives.

Dr. Richard Chazal, Lee Memorial Health System – Heart and Vascular Institute, shared some highlights from their co-management agreement that includes four hospitals and 45 cardiologists/CV surgeons. Dr. Chazal feels there are five key elements to the success of their program including:

• Mission hierarchy
• Dyad leadership team
• Financial commitment (hospital)
• Physician leadership
• Time commitment (physicians)

The lessons learned from the development and management of the service line in this co-management structure has allowed Dr. Chazal’s service line to flourish.
He offers that you must understand that definitions and values are different between the hospital and physicians. The program needs to incentivize what you want to happen, avoid politics and be inclusive. And, lastly, prepare for the long-term and exercise patience.

What successes have your co-management program experienced?