Treat clinicians as partners to drive value


Doctors may have the greatest impact on cost control in healthcare, but they rarely find themselves treated as full partners in the value-based care equation.

Administrators and payers tend to try to control clinicians’ behavior through payment incentives and other means that treat them as passive players in the cost-saving process, write Jonathan Warsh, Ph.D., of Harvard Business School and Michael Nurok, Ph.D., of Cedars-Sinai Health System in NEJM Catalyst. They argue that the current system rests upon the assumption that providers have less incentive to control costs than payers do.

While the shift in payment incentives has generated some progress toward better care outcomes, the real trick lies in aligning the incentives driving administrators and clinicians. “It is our contention that, in specific ways, hospitals and payers can do much more to engage clinicians as partners in helping to control costs,” the authors write. The article includes several tips for bringing clinicians to the table as an active partner in cost control:

  • It may seem obvious, but simply telling clinicians where cost pressures exist can lead to solutions that are less likely to backfire and hurt care quality, according to Warsh and Nurok.
  • Encouraging physicians to undertake business training offers an opportunity for clinicians and finance personnel to operate together on common ground, and can help clinicians better understand their role at the nexus of cost and quality of care.
  • Organizational structures that encourage administrators to work more closely with clinicians in order to understand their concerns, such as the patient-centered model implemented by the Cleveland Clinic, can drive both lower costs better outcomes by creating solid interdisciplinary teams.
  • At an industry level, the authors see a need for “a conceptual shift toward seeing clinicians as allies—and not adversaries” as organizations strive to marry lower costs to high care quality.