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Mary Greeley Medical Center (MGMC) worked with Huron to navigate complex regulatory and operational hurdles to successfully transition an independent cardiology practice to a provider-based department of the hospital, allowing for better support of both the communities it serves and its physicians.

Challenge

Facing increased competition in the market and wanting to strengthen hospital and physician alignment, Mary Greeley Medical Center (MGMC) sought to transition an independent cardiology physician practice to an outpatient department of the hospital.

With consumer and physician needs top of mind, leaders needed a transition plan that would increase consumer access to care while improving care coordination and providing higher-quality services for patients and their families.

MGMC leaders understood that the complex transition would require expert attention to operational readiness as well as federal regulatory requirements.

Approach

MGMC and Huron worked together to develop a plan that would keep physicians and consumers at the forefront while achieving the hospital’s business and clinical goals for transition.

Critical to this work was designing a work plan that adhered to the rules of various regulatory agencies, including the Centers for Medicare & Medicaid Services (CMS) requirements for provider-based clinics. This transition occurred during the first wave of COVID-19, requiring the team to adapt to a fluctuating care environment and patient care demands.

The approach included the following core elements:

Set up the transition for success: Huron worked with MGMC and practice physicians to gain an understanding of the goals of all stakeholders and establish transition criteria. From there, the team developed a recommended transition model inclusive of the benefits and drawbacks of transition.

Build the foundation: To ensure the organization had the right foundation to build a regulatory compliant and sustainable outpatient cardiology service department, Huron and MGMC developed a detailed work plan to include the hospital leadership accountability structure.

Establish regulatory criteria: Recommendations and plans were developed in accordance with regulatory criteria while driving financial health for the organization and providing an enhanced quality of care for patients. The team prioritized physician and hospital alignment with the execution of a professional services agreement (PSA) that mitigated the risk inherent in a complex payor environment and supported market-competitive compensation of clinicians. Additionally, Huron supported the review of all documentation submitted to CMS reflective of operational, billing and regulatory requirements.

Equally as important was the team’s work to expand cardiac diagnostic testing to include point-of-service testing within the clinic. This work served to increase patient access to critical tests and improved the overall care experience.

This was a complex transition executed during an extraordinarily complicated time. Huron developed a strong and productive working relationship with everyone involved and helped us navigate all aspects of what in the end was a successful transition to the benefit of the hospital, providers and, most especially, our patients.” — Gary Botine, Vice President and Chief Financial Officer, Mary Greeley Medical Center

Mary Greeley is a 220-bed regional hospital that provides healthcare to the residents of a 14-county area of central Iowa. It is one of only 12 hospitals in the country to achieve both the Malcolm Baldrige National Quality Award and Magnet designation program. The Baldrige award is the nation’s most important measurement of quality improvement and innovation. Magnet is the nation’s top recognition of nursing excellence.