Ce diaporama a bien été signalé.
Le téléchargement de votre SlideShare est en cours. ×

Physician Aligment - Evariant eBook

Chargement dans…3

Consultez-les par la suite

1 sur 35 Publicité

Plus De Contenu Connexe

Diaporamas pour vous (20)

Similaire à Physician Aligment - Evariant eBook (20)


Physician Aligment - Evariant eBook

  1. 1. Modernizing Physician Alignment Strategies with Data Analytics 001001000010101001 0101000 10101010101010101010100010 01001 0101000010101111001010 0101010001001000010101001 01011110010101010101010101010 00010101001 0101000010101111 10101010101010001001000010 010101010101010101010001001 0010101000100100001010100 10101111001010101010101010101 000010101001 01010000101011110010101010101010101010 10001001000010101001 010100001010111 100101010101010101010101000100100001 0101001 010100001010111100101010101010 1010101010001001000010101001 0101000 0101011110010101010101010101010100010 01000010101001 0101000010101111001010 101010101010101010001001000010101001 01010000101011110010101010101010101010 10001001000010101001 0101000010101111 001010101010101010101010001001000010 101001 0101010101010101010101010001001 0000101010010101000100100001010100 1 0101000010101111001010101010101010101 010001001000010101001 01010000101011110010 1000100100001010100 100101010101010101010 0101001 010100001010 1010101010001001000 010101111001010101010 01000010101001 01010 10101010101010101000 01010000101011110010 1000100100001010100 01010000101011110010101 10001001000010101001 0 10010101010101010101010 0101001 010100001010111 1010101010001001000010 010101111001010101010101 01000010101001 0101000 10101010101010101000100 01010000101011110010101 10001001000010101001 0 00101010101010101010101 101001 01010101010101010 000010101001010100010 1 0101000010101111001010 010001001000010101001 10001001000010101001 010100001010111 100101010101010101010101000100100001 0101001 010100001010111100101010101010 1010101010001001000010101001 0101000 0101011110010101010101010101010100010 01000010101001 0101000010101111001010 101010101010101010001001000010101001 01010000101011110010101010101010101010 10001001000010101001 0101000010101111 001010101010101010101010001001000010 101001 0101010101010101010101010001001 0000101010010101000100100001010100 1 0101000010101111001010101010101010101 010001001000010101001
  2. 2. Like this eBook? Take a moment to share it on your favorite social networking sites.
  3. 3. Evariant | 3 Physician alignment is critical to the success of your healthcare system. If your institution cannot secure strong alignment, it can have significant repercussions. In a recent study sponsored by Accenture, it discovered that U.S. hospitals that deliver superior patient experience generate 50 percent1 higher margins than average providers. According to another Accenture study, “seven percent of patients switched providers due to a poor patient experience. This switching translates to a loss of $100M in annual revenue per hospital.2 ” Indeed, a successful approach to physician alignment can impact your institution’s financial performance in many ways. To achieve both physician alignment and optimize patient care in today’s hyper-competitive environment, you must have a view into physician activity and referrals. Understanding physician behavior provides the basis for more meaningful dialogue with the physician so as to better modify and track future behavior and align physicians with your institution. Introduction Tweet this: Knowledge of physician activity + referrals is necessary to see successful #physicianalignment
  4. 4. Evariant | 4 However, as fast as the healthcare landscape is changing, so too are the methods and technologies you need to ensure successful physician alignment. We now realize it “takes a village” to keep your physicians happy, and that means just making phone calls and visiting physicians to promote your services is not enough. This eBook describes how to achieve better physician alignment through the use of data analytics to: Physician Alignment Value Cycle Physician Alignment More Revenue More Referrals Improved Physician Experience Improved Patient Experience Identify baseline issues that negatively impact physician and patient satisfaction Help your institution achieve its revenue goals Utilize relevant data-driven intelligence to conduct meaningful dialogue with physicians Improve referral rates
  5. 5. The Changing Healthcare Landscape Makes Physician Alignment a MUST
  6. 6. Evariant | 6 As the healthcare industry continues to evolve, it is critical that your executives, physicians, and administrative personnel stay informed about industry trends so you can continuously adjust your organization’s strategy to anticipate and meet market needs. The changing nature of your competition, the quest to improve the patient experience, and the on-going journey to optimize conventional and new, innovative patient channels are just a few examples of recent dynamic trends. Addressing these trends and tackling other business challenges are compelling healthcare organizations like yours to revamp existing strategies and implement modern technologies with the objective to garner more data and make more informed decisions to enfranchise both physicians and patients. According to Gartner, healthcare providers will spend approximately $108 billion on healthcare IT in 2016, with expenditures continuing to grow for the next five years3 . For most healthcare organizations, implementing and maintaining Electronic Health Records (EHR) and staying current on regulatory requirements have dominated IT spending in recent years. While we all hoped that the EHR could provide comprehensive data analytics capabilities, it doesn’t provide your organization with the necessary data to enable and facilitate physician alignment analysis and management to increase referrals and revenues.
  7. 7. Evariant | 7 Tweet this: Your org must have a #physicianalignment program in order to keep up with competition In 2016, Merritt Hawkins forecasts that a primary care physician will generate upwards of $1.4 million in revenue and some specialists will generate almost double that amount. Orthopedic surgeons can bring in $2.7 million on average across their affiliated hospitals. The average revenue of cardiologists, general surgeons, and neurosurgeons also exceeds $2 million and it is expected that these specialists will remain high-revenue generators even with capitation and value-based delivery models4 . That’s the good news! The bad news is that the Association of American Medical Colleges (AAMC) projects that by 2023 there will be a shortage of up to 90,400 physicians, of which 66,000 will be specialists5 . If your organization has not started executing a well-designed, well-funded physician alignment program, it cannot compete for the best physicians. Your competitors, who recognize the importance of physician alignment, will capture more physicians.
  8. 8. Evariant | 8 Your competitors will be able to capture your physicians (and patients) because they will have the following tactical advantages… A database that contains demographic and specialty information on all the physicians in their (and your) target market Continuous access to data and analysis of targeted physician referral behavior Better communication with physicians — affiliated or non-affiliated with their institution — with market insights to help initiate, frame and focus discussions A close-looped system to ensure activities are chronicled and action items addressed, resolved, and communicated back to the physician
  9. 9. Evariant | 9 ...to achieve strategic goals and realize incremental revenue by: Recruiting the best physicians and specialists for the right geographies at the right time Ensuring an on-going, enriched physician experience to keep physicians happy and improve referral rates Identifying and acting upon opportunities to improve market share of high-growth, high-margin services at the right locations Identifying appropriate entities for mergers and acquisitions Building out networks with affiliated physicians Identifying new delivery channels and services such as minute clinics and retail pharmacies
  10. 10. Achieving Physician Alignment Starts at the Top
  11. 11. Evariant | 11 The only constant in the healthcare industry is change, which is driven by on-going dramatic shifts in healthcare demand. Changing population and disease demographics, an increasingly urbanized population, unprecedented competition models, the advancement to patient-centric care, on-going healthcare reform, and the advent of healthcare consumerism are just a few examples of the forces driving change. In order to embrace these developments, and simultaneously protect revenues and ensure continued growth, healthcare institutions must create an ecosystem that aligns with each physician’s concerns and ambitions in order to extend its referral network and capture market share. The strategy to achieve alignment starts with organizational goals that are analyzed and incorporated into business development and physician enfranchisement plans. The strategy for success must start at the top, and fortunately, today’s health system C-suite executives are realizing they not only have the ability, but also the responsibility to contribute to physician alignment efforts. While the physician liaison program is most likely at the core, anyone who interacts with physicians is an asset in these efforts. Today, all parts of the health system can, and should, contribute to alignment success. Tweet this: #physicianalignment starts at the TOP. #CXO’s need to contribute to the effort
  12. 12. Evariant | 12 The ultimate goal of a physician liaison program is to increase in- network physician activity and patient referrals by building meaningful relationships with and improving services to physicians. The physician liaison is the steady contact between the healthcare institution and the physicians. The liaison is a well-trained professional and active listener with a deep understanding of market trends and the healthcare system’s services. On a day-to-day basis, the liaison works to cultivate a trusting, honest, and meaningful relationship — as the health system’s representative — in order to: • Improve the referral rates with network physicians • Identify out-of-network physicians who can bring in new referrals • Promote the organization’s core and specialty services to drive increased specialist activity • Escalate issues voiced by physicians and ensure resolution and communication back to the physician • Keep physicians aware of changes in the marketplace • Communicate new service/policy changes Achieving physician alignment is a tall order that requires a great deal of persistence. Results are not achieved overnight, and a “salesy” approach does not deliver the desired outcome.
  13. 13. How Physician Alignment Has Evolved
  14. 14. Evariant | 14 Initially, many physician alignment key performance indicators (KPIs) were narrowly focused on what could be counted: the number of liaison visits per week to referring physician offices, the number of social events scheduled with referring practices, the number of speaking engagements coordinated, etc. Along with updating sales plans and weekly sales activity reports, counting weekly activity was the only way a hospital could measure outreach productivity and ensure the liaison was spending an appropriate amount of time face-to-face with physicians developing relationships. Historical alignment efforts were also simplistic. Many organizations thought that acquiring Primary Care Physician (PCP) practices would provide a better opportunity to capture more downstream patients. Other approaches focused on employing a key specialist or acquiring a multi-specialty practice so the hospital would get more valuable cases. Generally, these approaches were an attempt to lock down patient streams. The problem with these approaches is that any given institution cannot acquire every practice or employ every physician in its target market. In addition, it did not focus on the key factor necessary to actually achieve physician alignment — building relationships. 13 3 8
  15. 15. Evariant | 15 Today, there are many “super system” integrated delivery networks that have emerged from this “land grab” and every health system is somewhere on an individual journey of building out a care delivery network, but not just through acquisition and employment alone. The efforts to secure physician alignment, whether performing in your facilities, mid-stream in the patient pathway, or all the way upstream have taken many forms. What we have learned from almost every journey is that real alignment is difficult to achieve. Tweet this: REAL #Physicianalignment is difficult to achieve. Persistence is required for success
  16. 16. Tools Necessary for Physician Alignment
  17. 17. Evariant | 17 Three Pillars of Physician Alignment What we have also learned over the course of these journeys is that to succeed with physician alignment, your organization must have three pillars to support the foundation of the program. First, your organization must have capabilities. These include an appropriate set of clinical capabilities and a reasonable infrastructure and network of physicians to deliver care. You also need a good patient experience and/or the commitment to continuously improve the patient experience. Second, you need human capital, which includes more than just a physician liaison. Human capital includes anyone who interacts with a physician. These include service line leaders, administrative executives, other physicians, and other specialists. You cannot underestimate the foundational need for and impact of interpersonal interactions when optimizing physician alignment. The third pillar for success — and the pillar we will focus on for the remainder of this eBook — is the technical tools, which includes a deep level of data and enabling platforms that facilitate physician alignment analysis and management. We call this technology a Physician Relation Management (PRM) system. Sophisticated PRM systems provide a 360° view of physician loyalty that incorporates market intelligence and insights into all physician activity across an organization’s target market. 1 2 3 Tweet this: Get a 360° view of physician loyalty across your hospital’s target market Capabilities Human Capital Technical Tools
  18. 18. Evariant | 18 To help discover a physician’s loyalty, the system analyzes how a physician interacts with other physicians and how a physician engages with your organization versus your competition, among other interactions. The 360° view includes: Market Physician Roster — This includes physicians across the specialties the institution needs for outreach — in a directory format. Complete Physician Activity — This includes activity of physicians that are and are not fully aligned with your organization. Accurate Referral Information — This is the crux of a sophisticated PRM system, which integrates de- identified, individual-level healthcare claims data from multiple independent data providers. This data is used to examine patient flow, identify which physicians are directing patients, what procedures they perform, etc. The challenges of identifying accurate referral information is further discussed in more detail in the next sections. Transparent Physician Relationships — The first three items above lead to transparent physician relationships, which includes much more than what the physicians tell us about themselves. Market Physician Roster Transparent Physician Relationships Complete Physician Activity Accurate Referral Information View of Physician Activity360°
  19. 19. Evariant | 19 In addition to providing the 360° view described above, sophisticated PRM systems must also be able to: Incorporate a workflow tool to customize the management of physician demographic information, track liaison activities, send emails, develop reports and inquiries, and manage issues. For example* Provide an architecture that allows the liaison to process a high volume of activity in a short time. This results in a high level of utility, efficiency, and ease of use to capture liaison activities with each physician or with the p hysician’s staff. Differentiate between high quality and routine interactions with any given provider. For example, a liaison may have 15 interactions a month with one physician, but only eight of those interactions are actual face-to-face meetings. For purposes of analyzing liaison productivity, you only want to include high quality interactions. With the support of modern PRM systems, healthcare institutions can set different KPIs tied to overall system growth and incremental revenue. Each healthcare organization can configure a workflow and notification system so that individuals who are responsible for resolving an issue are notified, as well as anyone interacting with the physician who needs to know about it. *Support Issue Management
  20. 20. Let’s Talk About PRM and Market Intelligence Data… And Its Complexity
  21. 21. Tweet this: See the steps you’ll need to take to identify referral patterns + get closer to #physicianalignment Getting PRM data “analysis-ready” is an extremelycomplex process. To give you a general idea of what’s involved, here is an abridged example of the steps it takes to identify referral patterns: Today, no universal source(s) of timely, comprehensive, detailed claims data covering all places of service and all payers (commercial or government) exists. Claims data is acquired from multiple clearinghouses that deliver it in inconsistent formats. As a result, any market intelligence system must normalize the data, e.g., put it all into one consistent format in order to manage it within one common structure. Claims are analyzed and grouped to determine the unique, de-identified patient ID. Claims are categorized to determine their primary purpose, e.g., orthopedic, dermatology, oncology, etc. This step is the one of most challenging because summarizing the myriad of potential diagnosis and procedure code combinations requires mass processing capabilities. Time sequences are developed based on each claim’s identifier. Different clearinghouses use different identifiers, so this data must be normalized and duplicate claims for the same person from different clearinghouses must be eliminated. A timeline is created for each patient to identify which physicians a patient sees and why. Each physician’s influence in the community and the flow of information based on the timeline is analyzed. PRM software vendors have developed an excellent methodology to weigh criteria to decide who likely made any given referral based on diagnosis and specialty. For example, Primary Care Physician (PCP) Dr. Jones tends to send patients to specialists Dr. Roberts, Dr. Carr, and Dr. Williams or the reverse happens. For example, specialist Dr. Roberts gets referrals primarily from a named roster of PCPs. There are many permutations. Determining the referral influence patterns is the core of the algorithm. While it is not the entire answer, the data provides directional insight that can serve as the basis for the liaison to ask the right questions of the physician to get a better picture of how they refer.
  22. 22. The Top 5 Healthcare PRM and Market Intelligence Data Challenges Tweet this: The top 5 #healthcare PRM + market intelligence #data challenges
  23. 23. Evariant | 23 There are further challenges to effective data analysis resulting from heterogeneous or missing claims data. Each healthcare institution files claims, with the data coming from their other Hospital Information Systems (HIS) or input by hospital personnel at the time of the encounter or shortly thereafter. Moreover, take into account all the ambulatory places of service types and it multiplies the variety of data inputs exponentially. For these reasons, many data elements are in different formats or are missing. As a result, here are five challenges necessary to overcome in order to obtain improved data accuracy.
  24. 24. Evariant | 24 Challenge #1 Billing Systems Are Fragmented and Dated An individual healthcare organization can have many billing systems that are dated and not integrated with each other, their HIS, or EHR. This increases the chance that some data elements, such as facility names, can be outdated due to mergers or acquisitions. For example, Bishop Hospital acquired Helen Hospital three years ago, but many billing systems have not been updated to reflect the acquisition and name change. There’s often confusion between Site of Service names (NPI 2) and/ or billing NPIs that can cause unusual results such as unexpected site of service names. Providers may be listed as seeing patients at a practice that clearly makes no sense (such as a vascular surgeon being connected to a gastroenterology practice). Or, physician names are listed as the site of service instead of the actual practice name. There may also be inconsistency in the name of the hospitals. For example, there can be multiple iterations for and entity like Sharon Regional Hospital, such as Sharon Regional Hospital, LLC or Sharon Regional Hospital, llc, resulting from how data is input, programmed, and set up into the different billing systems. Multiply the number of billing systems per healthcare system by the number of healthcare locations within a given target market (where you are analyzing claims) and the permutations can be difficult to track. To help address these data challenges, algorithms are developed that attempt to standardize and convert all possible variations. 001100101011101001001000010101010100010 0100010100100100100010011100000111010 01001001010010010010111010001010011 00110010101110100100100000110100100000 0001101011101010100100000010110100001010 100011000100010000110100010100101000 Hospital A Hospital AB ! ! Billing System 1’s Data Billing System 2’s Data
  25. 25. Evariant | 25 Challenge #2 Patients Do Not Have a Unique Patient Identifier Experts have argued the benefits and the pitfalls of a unique patient identifier since the Health Insurance Portability and Accountability Act (HIPAA) was signed into law in 19966 . Fast forward 20 years and, in the absence of a unique patient identifier, your organization will find it difficult to attribute claims to the right patient. A good example of patient I.D. problems is the result of the mother/ child relationship. Claims for a newborn and/or child are often filed under the mother’s information, not the child. This is why you may see some claims for the same individual with different dates of birth, e.g., the mother’s and the child’s. This happens for multiple reasons. Some insurance companies will not issue an insurance card for a child under a certain age, so the billing system uses the mother’s ID. Or, the newborn infant has not yet been added to an insurance plan, so claims are typically submitted under the mother’s ID. If every patient had a unique identifier, data matching would not be required. Until and if that happens, data matching mechanisms are required to look for these data anomalies and put the right patient claims together. ID#144000329 {
  26. 26. Evariant | 26 Challenge #3 Primary Diagnosis and Procedure Codes Are Unclear Procedure codes in claims data frequently are not marked as primary, or multiple codes are marked as primary. This causes confusion when trying to determine the primary purpose of the patient’s visit. For example, there may be anesthesiology-related procedures, cardiology- related procedures, and orthopedic-related procedures on the same claim and none or all are marked as primary. Determining the primary procedure is often handled via algorithms in industry-standard grouper tools that incorporate different methodologies, workarounds, and external data sources. For example, Evariant works around this issue with an algorithm that determines the one “primary” purpose of the claim by using Diagnosis-Related Groups (DRG) as a foundation and mapping International Classification of Disease (ICD)-10 and Current Procedural Terminology (CPT) codes back to summarize the massive quantities of information into useful service hierarchies.
  27. 27. Evariant | 27 Challenge #4 Available Claims Data is Highly Inconsistent As we discussed previously, there is no universal source of timely, comprehensive, detailed claims data covering all place of service types and all payers (both commercial and government). With claims data, any data field that is not required for payment has a low probability of being filled in or is inaccurate. For example, there are fields for “site of service” and “place of service” on each claim. The site of service is an actual facility (e.g., Smith General Hospital, Jones Outpatient Clinic), where the place of service is the type of facility (e.g., hospital, outpatient surgical facility, doctor’s office, etc.). Neither field is required, so both are frequently left blank or, due to less payer scrutiny, can be incorrectly completed. Another example is the use of National Provider Identifier 2s (NPI 2). Some locations of care are billed under a NPI 2 for a group practice or master billing NPI 2 related to imaging or radiology. However, the physicians or labs are located across 15 different sites, which makes it difficult to identify where care was actually rendered. To make matters worse, they may all be billed through a central facility in a different state. So, Dr. Smith may bill out of Charlotte, NC even though the patient walked into his office in Greenfield, VA. Insurance companies may not care about site and place of service as much but, obviously, when using the data to determine referral patterns, these fields matter. Patient A Tweet this: Big challenge: claims data is often inconsistent or inaccurate
  28. 28. Evariant | 28 Challenge #5 It’s Difficult to Identify the Referring Physician Increasingly, patients are encouraged, directed and incentivized to research doctors on their own. But, technology solutions have not yet advanced far enough to accurately capture or even quantify self- referral activity by patients. For now, most referrals are physician generated, but as previously mentioned, billing systems and EHRs are often not integrated so capturing quality referral input is extremely difficult. The “referring physician” field on available third party claims is often inconsistent, incorrect or, most often, missing. For example, a patient presents at an Emergency Room (ER). The admissions staff may ask for and enters the patient’s PCP in the “referring physician” field. In fact, some clearinghouses don’t even provide the “referring physician” field because of these inconsistencies.
  29. 29. Better Data Equals Better Physician Alignment Tweet this: #Hospitals need every advantage to keep & grow market share. Better #Data = better #physicianalignment
  30. 30. Evariant | 30 “The Affordable Care Act’s emphasis on quality outcomes, satisfied patients, cost-effective care and continuous improvement, which is the reality for all hospital leaders today, is grounded in the availability of meaningful data and leadership’s ability to analyze and use it to benefit patients and themselves.” —Dr. Dighton Packard Becker’s Hospital Review7 Your healthcare organization needs every advantage to stay competitive in today’s market. What separates the enterprising healthcare institutions from the ineffectual ones is the ability to access physician and claims data, segment and analyze it to gain actionable insights, and execute on those insights. Acting on data dictates which healthcare organizations gain market share and which organizations lose market share, which make money and which lose money.
  31. 31. Evariant | 31 One Chicago-based health system believes that data is a key component to achieve physician alignment. Data empowers their physician liaisons to successfully engage physicians and influence the organization. The key to its success is not to just capture the data, but to fix any erroneous or incomplete data at the source, even before using it. To help improve consistency in a system where 900 individuals were entering referral data, the institution improved its EHR system and other operational processes by standardizing the format and instructions for data entry fields in order to enhance referral tracking and communication flow back to the referring physicians. Once the data was fixed, the health system developed a repeatable process for strategic planning and outreach. It used both internal and external data to analyze opportunities for deeper alignment, to tailor their messages to potential referring physicians, and to monitor both the outreach and the outcome. This health system is an excellent example of how to utilize data and analytics to achieve the physician alignment goal. While this organization is still in the midst of implementation, it has already increased revenue from 23 referring physicians by 845 percent in FY15 from $718,000 to $8.5 million. Dignity Health’s year-over-year incremental revenue contribution grew to $56M after incorporating this sort of data-driven approach into their strategic outreach planning. Success stories from other health systems Read the whole story
  32. 32. Evariant | 32 Conclusion It is not surprising that healthcare executives are rating physician alignment as a top concern. In a recent article published in Hospitals and Health Networks, the authors state, “As the market shifts toward financial incentives for quality, cost control and experience, closer collaboration between physicians and systems becomes a necessity. Even organizations that are primarily focused on fee-for-service strategies are reconsidering physician alignment with an eye on the value-based future.8 ” However, it is important to recognize that the methods and technologies you need to support a successful physician alignment strategy have changed over the years and today they are changing at a faster rate. Before PRM systems were developed, a healthcare organization was lucky if it had access to a database that contained physician contact information. Even if one existed, it often only contained information about internal physicians. Aside from contact information, most other “intel” about a physician was provided by the physician when meeting with the liaison. The more sophisticated liaisons would document these findings in spreadsheets. Some institutions still rely heavily on Excel as a way of collecting and recording information. Even today, many PRM systems only provide data about physicians already employed by or associated with their healthcare system and any “analysis” only includes certain types of internal data. The problem with this approach is that an institution “doesn’t know what it doesn’t know.” There is no view into physicians outside of the healthcare network and even for affiliations, there is not enough depth of data and actionable insights. Today, rapidly advancing data analytics ushers in a progressive era for physician alignment. Now more than ever, your institution can achieve a view into all physicians in your target market, analyze their claims data to discover their loyalties, engage in more meaningful dialogue, identify and resolve physician issues, and build relationships based on respect and trust. And all of this has the potential to give your institution the competitive advantage it needs to achieve successful physician alignment, increase volumes and referral rates, and realize incremental revenues. Tweet this: Tips on giving your organization a competitive edge when attempting to achieve #physicianalignment
  33. 33. Like this eBook? Take a moment to share it on your favorite social networking sites.
  34. 34. About Evariant Evariant sees a future where healthcare organizations deliver precise, efficient care solutions not only inside an organization’s walls, but also beyond. We make this a reality by continuously innovating a healthcare CRM platform—a platform based on a centralized healthcare data hub, analytics, and communications engine—capable of identifying, executing, and measuring all types of engagement initiatives. With the Evariant Physician Relationship Management (PRM) solution, healthcare organizations can understand physician network trends, prioritize and better target physicians, and drive referral volume and in-network physician activity. Evariant believes that connecting insights that inform engagement will transform the healthcare experience.See it in action Contact us for more information. 888-444-3598 | evariant.com | connect@evariant.com
  35. 35. Sources 1. Collier, Matthew and Basham, Leslie Meyer, (2015) Accenture: Patient Engagement: Happy Patients, Healthy Margins. Retrieved August 31, 2016 from https://www.accenture. com/t20151003T033201__w__/us-en/_acnmedia/Accenture/Conversion-Assets/ DotCom/Documents/Global/PDF/Industries_17/Accenture-Happy-Patients-Healthy- Margins.pdf#zoom=50 2. Safavi, Kaveh, MD, JD and Sarasohn-Kahn, Jane, (2016) Accenture: Platform Economy, Ecosystems are the new bedrock of digital healthcare. Retrieved August 31, 2016 from https://www.accenture.com/us-en/insight-platform-economy-digital-health 3. Gupta, Anurag, (2016) Gartner Report: Market Trends: Four Major Opportunities in the U.S. Healthcare Provider Market. Retrieved August 31, 2016 from https://www.gartner. com/doc/3283533/market-trends-major-opportunities-healthcare 4. Merritt Hawkins, (2016) 2016 Physician Inpatient/Outpatient Revenue Survey. Retrieved August 31, 2016 from http://www.merritthawkins.com/uploadedFiles/ MerrittHawkins/Surveys/Merritt_Hawkins-2016_RevSurvey.pdf 5. Dall, Tim; West, Terry; Chakrabart, Ritashree and Iacobucci, Will, (2015) Association of American Colleges: The Complexities of Physician Supply and Demand: Projections from 2013 to 2025. Retrieved August 31, 2016 from https://www.aamc.org/download/426242/data/ihsreportdownload.pdf 6. Skerrett, Patrick, (2016) Experts argue the benefits, pitfalls of a unique patient identifier. Retrieved August 31, 2016 from https://www.statnews.com/2016/01/28/ experts-argue-unique-patient-identifier/ 7. Packard, Dighton, MD, FACEP, (2016) 5 Ways to improve physician hospital alignment. Retrieved August 31, 2016 from http://www.beckershospitalreview.com/hospital- physician-relationships/5-ways-to-improve-physician-hospital-alignment.html 8. Hamory, Bruce M.D.; Smith, Graegar and Singh, Rohit, (2016) 5 Practices That Can Help Health Systems Build Improved Relations With Doctors. Retrieved August 31, 2016 from http://www.hhnmag.com/articles/7186-practices-that-can-help-health-sytems- build-improved-relations-with-doctors