![Comanagement Arrangements And Medical Directorships Web](/Areas/CMS/assets/img/blank.gif)
大多数医院的管理人员至少对“管理安排”这个词很熟悉,” but the concept has different meanings for different people.
Broadly speaking, 管理安排是一种协议,根据该协议,bet8网站备用与医院签订合同,与医院管理部门合作,管理特定bet8娱乐项目的护理bet8娱乐. bet8网站备用参与日常操作的管理,并激励他们实现既定绩效指标的目标.
But before exploring the details of what a comanagement arrangement is, it may be helpful to understand what it is not. Specifically, a comanagement arrangement is not a medical directorship. 医务主任负责领导bet8娱乐部门,并协助开展业务, fiscal, and human resource management.
虽然管理协议包括相同的bet8娱乐,但它更进一步. 参与管理安排的bet8网站备用能够提供比单个医疗主任更深入的bet8娱乐,并且与医院管理部门更加协调.
这两个术语之间的区别既不是微不足道的,也不是学术上的——它会对公平市场价值(FMV)的确定产生直接影响.
Understanding the Difference
一些愤世嫉俗的观察家将管理层描述为“打了类固醇的医疗董事”——这是增加医疗董事工作时间和小时工资的一个几乎不加掩饰的理由. 如果管理只是医疗主管在维持运营现状的同时赚更多钱的一种手段,这些指控可能听起来是对的. 但是,对医疗董事的额外补偿——即使是由于取得了非凡的成绩——也不会将董事职位转变为管理bet8娱乐.
一个真正的管理安排不仅仅是bet8网站备用提供的几个行政时间, 或者是第三方管理费,医院几乎没有行政参与. If done correctly, 管理安排可以成为推动整个企业价值的强大工具, especially for hospital patients. 管理协议的结构应经过深思熟虑,以协调多位bet8网站备用和医院领导之间的bet8娱乐. bet8娱乐线路的质量应该有所提高,从而为患者提供更有效的bet8娱乐.
The two arrangements may incorporate aspects of each other, 因此,“管理”对不同的人意味着不同的东西也就不足为奇了. 下面的图表有助于说明这两种安排的区别:
Comanagement | Medical Directorship |
Compensation is based on results. | Physicians are compensated for their time. |
Usually a separate management company | Compensation is paid directly to the physician. |
Physicians are usually not employed. | Physicians can be employed or independent. |
多名bet8网站备用和医院管理人员参与其中. | A single physician serves as the medical director. |
Getting the Valuation Right
未能区分医疗董事和管理安排将直接影响协议的估值. 如果医疗董事职位被视为一种管理安排,医院可能会给bet8网站备用开出过高的薪酬, 或者,如果bet8网站备用提供更全面的bet8娱乐,他们可能会少付他们的钱.
评估管理安排的价值的过程比评估医务主任职位的价值更为复杂,因为涉及更多的提供者,而且在执行协议时需要进行协调. Medical directorships are typically valued based on time spent.
没有适当地重视你的安排可能有两个主要的影响.
Getting What You Pay For
没有适当激励的管理安排更像是医疗董事. Incentive metrics are frequently overlooked in FMV and CR opinions, and valuators should carefully scrutinize them. 如果薪酬与激励成分没有充分联系起来,bet8网站备用就不太可能看到bet8娱乐部门业绩的积极转变, 或者,如果性能已经达到目标指标,不需要进行改进. Performance measures must be based on some level of improvement to the service line; otherwise, physicians are being paid to maintain the status quo.
Government Scrutiny
未能适当地构建和重视管理安排的组织可能会违反联邦法规. In August 2018, William Beaumont Hospital was ordered to pay $84.500万美元,以解决因向转诊bet8网站备用支付不当款项而引发的《bet8娱乐》指控. 政府援引一名举报人的话说,心脏病专家获得了医疗主管职位,但几乎没有任何工作, and that the true purpose of the payments was to induce referrals.
博蒙特案的部分问题源于医院支付医疗董事的费用与管理安排分开——这是一个商业合理性问题, as organizations are more likely to pay for the same service twice. Because the base fee services are very similar, 医疗董事的职责通常包括在管理协议中. 如果医疗董事的薪酬与管理安排分开支付, 然后,组织就会冒着堆积bet8娱乐的风险,并为没有提供bet8娱乐的bet8娱乐付费.
Keeping up with Your Comanagement Arrangements
Since comanagement agreements are, by nature, meant to move specific performance goals forward, bet8娱乐部门主管应每年审查绩效指标. Do the metrics improve the service line or simply maintain it? If the service line is not improving, 那么bet8网站备用就不应该继续收取绩效指标的报酬.
Additionally, if a management entity is expected to transform the service line, more compensation should be available to the physicians. But this arrangement should not be continued into perpetuity; if incentive compensation is being paid, this means performance targets are being met, and as such, new goals should be developed for the next arrangement year.
Given this complexity of these arrangements, and the potential for their goals to change over time, 管理协议应由独立评估师定期审查,以确保满足FMV和CR.
Comanagement arrangements in need of a refresh?
Read Reviving Your Worn-Out Comanagement Arrangement to get started.
Read NowPublished June 26, 2020