Articles: Physician Integration & Alignment

Clinical Co-Management: Driving Service Line Success through Shared Leadership

by C.B. Rebsamen, MD, FACHE, Rachael Schad and Karen Corrigan

Clinical co-management is an integration structure gaining renewed interest from both hospitals and physician organizations.  Under the co-management arrangement, hospitals contract with an organized group of physicians to provide day-to-day management services for inpatient and outpatient components of a specialty service line such as cardiac, oncology or orthopedics.  The first generation of co-management was an outgrowth of gainsharing where physicians benefitted from cost-savings arrangements.  Most of these early models, however, faded quickly once savings reached a point of diminishing returns.  And many failed when financial rewards didn’t materialize because cost improvements weren’t achieved.

This article describes how a new generation of clinical co-management ventures offers substantially more value in that agreements between hospitals and physician organizations provide for and reward physician engagement and leadership in a broad spectrum of activities that improve patient care and outcomes, generate cost efficiencies and make the clinical service more competitive in the market – and how patients become the real winners when aligned hospital-physician incentives have a positive impact on patient care.