A growing trend in the direction of physicians and hospitals is linked to professional services agreements (“PSA”). An PPE is generally defined as a financial relationship between a medical practice and a hospital where the medical practice remains an autonomous unit, but where doctors are compensated by the hospital at fair value for their professional services. Among the basic elements of a traditional PPE are: what are the remuneration structures of doctors to generate efficiency and quality care for patients? Specific components of financing, such as incentives for productivity and performance, as well as the overall balance between risk and reward for the supplier, should be taken into account. Chad Mulvany of the HFMA says it is imperative that everyone in the U.S. supports safety hospitals, or there will be an increase in the differences in access to basic health services between having and nothing.  Becker`s Hospital Review. 7 things hospitals should know about professional service agreements. www.beckershospitalreview.com/hospital-physician-relationships/7-things-hospitals-should-know-about-professional-services-agreements.html. May 2012. We assume that health care professionals who read this article are unlikely to need further study of the benefits of the acquisition or the factors that drive private equity systems and companies to purchase practices.
Instead, we want to use this Coker connection to highlight some of the off-use options that practices and systems can use to achieve better results. There are signals in the market that independent practices are not decreasing as much as the above articles suggest. It was only last October, at the mgMA 2018 annual conference, that a group of doctors shared some of the unintended consequences – increased costs, withdrawal of doctors, flat or declining results – of this flow of acquisitions, predicting that independent practices could return in the near future.  So whether our readers come from large systems, private equity firms or private firms, we hope that this piece will serve as a productive reminder that employment is not the only option to track the alignment between doctors and hospitals or health systems. Depending on the situation, the structures described below may show an upward trend similar to that of employment or acquisition without the same unintended consequences or risks. Improving the model of care. As a result of the shift to value-based care, health systems and medical practices are evolving into a transformation of the care model, which involves adopting processes and developing skills that help them compete for quality and accessibility and take risks for large groups of patients. These efforts require coordination of care, clinical standards and protocols, clinical innovation, the provision of quality care and the commitment of providers, all of which are often poorly defined or totally excluded from PSAs.