Thinking Outside the Box to Build a Winning Partnership

A multispecialty medical group aligned with a regional health system operated under a carve-out Professional Services Agreement (PSA). Under the agreement, certain specialists were contracted exclusively to the health system and reimbursed on a perwRVU basis, with the health system also managing payer relationships.

Upon engagement, the team identified several key challenges:

• Limited Engagement of Primary Care Physicians: Primary care doctors weren’t included in the agreement, leaving them disconnected and misaligned with performance incentives.
• Technology Alignment Gaps: Strong differences of opinion existed within the group about the right vendor platforms for clinical documentation and practice management, making consensus and long-term IT planning challenging.
• Contractual Ambiguity: The PSA lacked clear options for appeal or agreement on certain terms, making future negotiations and continuity a concern.

These gaps threatened clinical efficiency and financial performance, making it harder to collaborate effectively, standardize clinical care, and optimize the patient experience across the network.

We worked closely with both parties to create a collaborative transaction and governance structure that aligned incentives, leveraged technology, and prioritized patient-centric outcomes:

1. Negotiation and Structuring the Deal: The team acted as a neutral advisor and structured the agreement, identifying revenue opportunities for both parties, including ancillary services like advanced imaging, clinical trials, and telehealth expansions.
2. Developing a Technology Sharing Model: We proposed an EMR Stark donation agreement wherein the health system would cover 85% of software-related and designated hard costs annually. This structure gave the medical group access to best-in-class clinical and operational technology platforms, reduced overhead, and enhanced clinical workflow efficiency.
3. Aligning Governance and Control: We facilitated agreement on key issues such as vendor oversight, IT control, and future procurement. This ensured long-term trust between the parties and a framework for making collaborative decisions about clinical and operational tools.
4. Delivering an HCIT Awareness Study: We comprehensively reviewed the current vendor landscape and forward-looking trends, providing actionable insights enabling both parties to optimize technology for clinical efficiency, patient engagement, and value-based care.