Op-Ed from the Alliance of Community Health Plans:

As the healthcare system shift from fee-for-service to value-based payment gathers steam, community health plans are actively working with physician leaders and partnering with physicians who will continue to lead our organizations toward better healthcare. Through embracing the power of physician leadership, our organizations are better able to steer the healthcare system in the right direction, toward one that always works to improve the quality of care, the experience of our members and patients, and the affordability of care for those we serve.


Some examples

  • Capital District Physicians’ Health Plan

One example of helping smooth the way to new models of care is the Enhanced Primary Care (EPC) system. The EPC model is intended to help primary care physicians transition to patient-centered medical homes (PCMH). Often, a single physician serves as a champion and team leader, helping colleagues work through the challenges of changing how they work while providing valuable front-line input to health plan leaders. At Capital District Physicians’ Health Plan in Albany, New York, we have found that EPC practices have improved patient experience while simultaneously reducing the cost of care for the sickest 10% of patients.

  • Independent Health

This new era of physician leadership is also seeing the blossoming of unique training approaches, which often draw out positive personality traits such as optimism, progressive thinking, and the ability to engage. At Independent Health in Buffalo, we have found that collaborative, physician-led PCMH initiatives have the power to change the interactions between primary care physicians and specialists, creating systems, and a culture that makes it easier to talk with and listen to each other more effectively.

  • Health Partners

At HealthPartners in Minneapolis, we have seen how creating collaborative physician-administrative leader teams allows in-situ leadership development and can help bridge the gap between potentially siloed operations to build common-sense patient-centered solutions. In one example, integrated teams joined forces to develop a new system for more effectively supporting decisions regarding appropriate ordering of imaging tests that met the patients’ and clinicians’ clinical goals, decreased radiation exposure, and decreased cost.

  • Kaiser Permanente

Kaiser Permanente (KP) has offered our physicians leadership training opportunities for many years. Mostly led by physician executives, these programs focus on the spread of successful clinical practices, change management, communication and interpersonal skills, and performance management and evaluation. By fostering a culture of learning from within, we are instilling a passion for lifelong learning in our leaders, with the expectation that they will pass that passion and knowledge on to their colleagues.


The tipping point

For those of us long dedicated to the vision of physician accountability for high-quality healthcare, this spring’s passage of the Medicare “doc fix” legislation was an enormously promising sign. With major changes afoot regarding how Medicare and others pay for healthcare, the move to a value-based system is finally reaching a tipping point.

Ultimately, however, making the journey from volume to value will require a new set of skills for all in healthcare, from building teams to working collaboratively and thinking strategically. Physician leaders are one of the keys to the improved health, affordability, and system transformation we plan to achieve.

Authored by physician leaders from 4 ACHP plans:


Please enter your comment!
Please enter your name here

This site uses Akismet to reduce spam. Learn how your comment data is processed.