The role of clinical leaders in accountable care organizations

Editor's Note: This is the first of a two-part interview with Heritage Medical Systems President Mark Wagar. Part 1 discusses the importance of clinical leaders in the success of accountable care organizations (ACO). Part 2 will highlight the strategies the Heritage Provider Network implements to encourage innovation within its Pioneer ACO.

Healthcare organizations that want to succeed in the current accountable care climate must develop their physicians as leaders, says Mark Wagar (pictured), president of the physician-led Heritage Medical Systems in Palm Springs, California, an affiliate of the Heritage Provider Network (HPN), one of the country's biggest ACOs.

Wagar, who spoke to FierceHealthcare in an exclusive interview, says that the most successful healthcare organizations rely on input from their physicians. In fact, Heritage was founded by one such physician leader, Richard Merkin, M.D., nearly 35 years ago.

But hospitals and health systems don't have 30 years to develop clinicians as leaders, Wagar says. They must act now.

"[For] everything I've been involved in with healthcare that was a success, there was always a clinical leader either leading it, providing input, collaborating, supporting it and advocating it," he says. "If it fell on its face, somewhere along the way, the clinicians weren't invited to the party or weren't listened to."

And clinician involvement is one of the reasons that Wagar believes the HPN Pioneer ACO was one of the few Pioneer ACOs that recognized savings in its first year. HPN has clinician leaders in markets where they can collaborate with independent practices, small groups and providers in the community.

Heritage chooses clinician leaders from different areas--not necessarily a practicing physician or an outstanding cardiologist. The decision is based on whether they are open to new ideas or understand primary care and patients' and their families' needs, he says.

"Big credentials don't mean big leaders," Wagar says. "The best leaders look at the whole, they have a superior ability to collaborate and get information for their colleagues and interact in different ways."

The key, according to Wagar, is that organizations must invest in resources to develop the leaders so they aren't stretched too thin. HPN, he says, has up and coming physician leaders spend time with experienced leaders--similar to how they practiced during their residencies when they spent time watching and listening before tackling a procedure on their own.

"It's hard to carve out this time, when everything is cut, but if you don't invest in leadership you won't be successful," he says.