Insights from Ludi

Health systems are expanding and continue to acquire new facilities. This type of growth requires examination of all the legacy physician “deals” that are in place. Yet, at Ludi^TM, we often hear that examination of physician administrative contracts that include medical directorships, co-management, and shared or on call agreements are often put on the back burner for health system teams. We get it, management of physician contracts is messy, and teams do not get overly excited about having to deal with this process. Teams are short on time and people, so this is the bucket that gets pushed down the priority list or even completely ignored.

Given that it is May 1 and you will likely be staring at a stack of 100 time logs from physicians who want to be paid, here are 3 tips for minimizing compliance errors:

Physicians have not traditionally entered the workplace to lead or run businesses; they want to care for people, heal their communities, and make a good living. With all the complications in healthcare, regulations, how to care for patients and remain profitable, physicians are being tapped daily for “extracurricular” management work.

Our hospital clients have let us know that the handling of physician administrative contracts is a “hot potato” within their administrative team. Nobody seems to want to fully own the issues that come along with these complicated contracts; everyone seems to own a piece of physician administrative contracts such as compliance, medical staff offices, hospital administration, legal teams and the finance department.

Administrative physician agreements have been written for your physicians with help from your legal department or counsel. The clauses are there to be followed for numerous reasons. Perhaps it is to meet your organization’s goals with the way you align with doctors as well as for a variety of compliance reasons. Whatever the reason, it’s important to handle your physician agreements in the way they’re written, even if they’re complex. Failure to do so leaves room for incredible consequences that can affect your organization in a variety of ways.

Hospitals pay a plethora of physicians in a variety of ways. Some are employed. Some manage the clinical components of service lines in tandem with hospital leadership in co-management arrangements. Some are service line leaders. Some provide on-call coverage for the hospital. Some teach residents or interns at the hospital.

At Ludi, our sole focus is physician administrative contracts. These are the legal vehicles that contain a variety of administrative services that physicians provide to hospitals that are not clinical. These services include medical directorships, on-call, co-management agreements, and physician committee work to name a few. We work with various sizes of health systems and have noticed several patterns, regardless of size, that all hospital administrative teams fall into when automating their manual processes that currently support their payment processes and executive of their physician contracts.

Physician contracts should, in theory, be created using templates as a best practice. The reality is that physician contracts are like snowflakes: it’s difficult to find two that are alike. In practice, having too much variation in your physician contracts can be detrimental to the organization. High level of variation can lead to operational problems while trying to execute agreements.

Ludi has had the pleasure of reading close to 7,500 physician contracts in the last three years. From this experience comes a tip sheet on how to construct the optimal physician contract.