Next Generation Provider Resource Planning
An analytical-based Provider Resource (Needs) Plan has long been a staple of health system strategic planning efforts. Such plans have guided health systems in developing recruitment plans for primary care physicians and specialists from both an overall community perspective and a strategic perspective. The key assumptions used to calculate provider needs within these plans have been relatively straightforward – physician-to-population ratios vs. community provider lists for the service area as a whole, adjusted for health system market share and provider loyalty in completing the strategic need analysis.
However, this standard template for provider resource planning has become less relevant in today’s healthcare environment. Today, more providers are employed by a health system rather than in private practice and the industry-wide value transformation requires new approaches to the patient care model. The whole provider needs question has become multi-variant, and therefore challenges health systems for renewed critical thinking.
FTI Consulting recently took on this challenge by assisting a regional, multi-state health system in the western U.S. to develop a fresh approach to its provider resource planning. This work involved developing traditional community and strategic needs analyses as a baseline, and then incorporated detailed analytics from multiple disciplines, including clinical operations, physician enterprise management and contracting. FTI worked collaboratively with health system leadership to develop a robust methodology that ensured that the plan reflected the system’s emerging care model and supported growth initiatives. The methodology included analytics such as:
- Identifying operational improvements in access, scheduling and productivity for the system’s physician enterprise, ensuring that incremental provider recruitment reflects true need rather than reinforcing existing inefficiencies;
- Responding to transformed care team models, including physicians, mid-level providers and other professionals (e.g., mental health professionals, nurse navigators) reflecting “top-of-license” practice;
- Incorporating changing utilization patterns in a value-based/population health environment, including greater focus on primary care and medical homes;
- Adjusting for individual-community specific health status indicators, rural healthcare factors, coverage models and other service area-specific nuances;
- Accounting for emerging technology, such as virtual visits and telemedicine, as well as impacts that prevention and pharmaceuticals have on the frequency of downstream interventions and specialty treatment; and
- Striking a strategic balance by specialty between employed physician recruitment and alignment/support of private practice groups in each market.
The work resulted in a “New Care Model Provider Resource Plan” that more accurately reflects both the environmental and organization-specific transformations that are impacting the health system’s care model and strategic growth initiatives, which they are using as a roadmap in recruitment decisions. While the fast evolving healthcare environment has somewhat dated the traditional template, a strategic Provider Resource Plan – if holistic in its incorporation of operational and macro environmental factors – is more important than ever to assure that healthcare organizations are prepared to meet current and future provider needs.