Physician Engagement Strategies in Care Coordination: Findings from the Centers for Medicare & Medicaid Services’ healthcare Innovation Awards Program

Skillman M, Cross-Barnet C, Singer RF, Ruiz S, Rotondo C, Ahn R, Snyder LP, Colligan EM, Giuriceo K, Moiduddin A
Source: Health Serv Res
Publication Year: 2017
Patient Need Addressed: Care Coordination/Management
Intervention Type: Staff design and care management
Study Design: Mixed-Methods
Type of Literature: White
link: https://www.ncbi.nlm.nih.gov/pubmed/27910099
Abstract

OBJECTIVE:
To identify roles physicians assumed as part of new healthcare delivery models and related strategies that facilitated physician engagement across 21 healthcare Innovation Award (HCIA) programs.

DATA SOURCES:
Site-level in-depth interviews, conducted from 2014 to 2015 (N = 672) with program staff, leadership, and partners (including 95 physicians) and direct observations.

STUDY DESIGN:
NORC conducted a mixed-method evaluation, including two rounds of qualitative data collected via site visits and telephone interviews.

DATA COLLECTION/EXTRACTION

METHODS:
We used qualitative thematic coding for data from 21 programs actively engaging physicians as part of HCIA interventions.

PRINCIPAL FINDINGS:
Establishing physician champions and ensuring an innovation-values fit between physicians and programs, including the strategies programs employed, facilitated engagement. Among engagement practices identified in this study, tailoring team working styles to meet physician preferences and conducting physician outreach and education were the most common successful approaches.

CONCLUSIONS:
We describe engagement strategies derived from a diverse range of programs. Successful programs considered physicians’ values and engagement as components of process and policy, rather than viewing them as exogenous factors affecting innovation adoption. These types of approaches enabled programs to accelerate acceptance of innovations within organizations.

Insights Results

Overview of article

  • The goal of this study was to illustrate how organizations and programs can foster physician engagement to effectively implement programs and achieve innovation success. Physician outreach was an important part of these efforts. This study identified roles and responsibilities that physicians assumed as part of new healthcare delivery models in these programs and studied how programs engaged physicians. The findings include strategies that facilitated establishing physician champions, garnered physicians’ buy‐in to the values of the innovation, and contributed to implementation effectiveness

Methods of article

  • Researchers conducted a mixed-method evaluation, including 2 rounds of qualitative data collected via site visits and telephone interviews

Results

  • This study determines that leveraging physician champions and establishing innovation‐values fit between programs and physicians were critical parts of engagement. The study identified four common physician engagement practices: involving physicians early in program implementation; conducting formal physician outreach and education; tailoring working styles to physician preferences and prioritizing communication with physicians; and sharing program data with physicians. The most common successful strategies that programs employed were tailoring teams’ working styles to meet physician preferences and conducting outreach and education
  • Consistent with prior research, this study finds that effective physician engagement requires multiple approaches tailored to organizational contexts. In addition, this study found that the use of financial rewards play a significant role in engaging physicians. healthcare Innovation Award (HCIA) programs worked best when they appealed to physicians’ natural motivations

Key takeaways/implications

  • Overall, this study suggests integrating physicians into care teams by providing tailored education and effective communication can be major drivers of positive change. These successful practices address primary concerns of physicians in the contemporary universe of healthcare provision: 1) Administrative burden; 2) Communication challenges; 3) Lack of organizational support; 4) Being forced into leadership roles without preparation; and 5) Increased demands on time. However, the question of whether physician engagement actually leads to improved patient outcomes for certain chronic diseases is beyond the scope of this study but deserves more research attention
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