The Five Elements of Optimal Care Delivery: Achieving Effective Clinical Alignment

Effective clinical alignment is one of the five strategic elements of achieving optimal care delivery. Let’s zoom in on this key element, which is an evolving necessity in today’s healthcare environment.

What does “alignment” mean?

In healthcare, the word “alignment” is used a lot, but is often misused and misunderstood. Across the industry, the definition and use of “alignment” can be varying and vague. Some people may use “alignment” to capture multiple discrete concepts in one fell swoop, such as engagement, loyalty, integration, collaboration and agreement. Regardless of the term or definition, alignment cannot be forced on clinicians. Alignment must be garnered through trust, experience and a commitment to shared decision-making.

So, what does clinical alignment really mean?

It is an arrangement between health system leadership and clinicians that is mutually agreeable and supports practices that are in the best interest of the patient, as well as the viability of both the health system and the physician practice enterprise.

It can’t be oversimplified.

Traditionally, clinical alignment has been oversimplified to models of employment and compensation plans that establish baseline levels of performance with rewards largely based on productivity. In the past, if clinicians were productive, referred their patients in network and admitted them to the hospital, they were thought to be aligned.

Proving alignment used to mean:

• Transitioning to an employment model with medical group from private practice.
• Achieving productivity levels at or above expected benchmark performance (i.e., typically 75th – 90th percentile), often through expanded access and increased new patient visits.
• Ensuring patients were referred within network to another employed provider.
• Admitting patients to health system-owned facilities.
• Ensuring patients use system-owned ancillary and testing services.

The concept of alignment is evolving.

As healthcare continues down the path toward value-based payment and successfully managing populations, the industry’s interpretation and execution of hospital-clinician alignment must also evolve. While many of the tenets in the old definition of alignment still apply, the requirements are changing.

Today, clinical alignment should include:

1. A demonstrated ability to achieve required quality measures.
2. Adherence to evidence-based clinical pathways – including appropriate utilization.
3. Appropriate levels of service (e.g., patient access, referring provider communication and care coordination).
4. An ability to support patient needs through alternative modes of care (e.g., telemedicine and virtual visits).
5. A referral system within a defined provider network (i.e., a clinically integrated network).

As the focus between health system and clinician teams begins to shift toward value-based care, the conversations are changing. This requires a different capability relative to business intelligence, a change from the traditional areas of focus, and most importantly, engagement of the patient to help inform new models of care delivery.

While it is difficult to truly become aligned, it is even more difficult to navigate these changes within a constantly shifting landscape across the health system and physician enterprise.

Next in our blog series on care delivery optimization, we’ll provide insight on transforming care processes across the continuum. Check out our latest blog discussing organizational readiness and download our Creating a Culture of Optimal Care Delivery white paper to learn more.