Regardless of where we look, it is also important to recognize that many of the programs and associated metrics being measured are focused on reducing emergency department visits. We are, therefore, looking at a potential revenue hit for emergency medicine practices, especially in hospitals developing these programs that are many times formed from partnerships of hospitals and insurance plans.

When evaluating an ED practice, Alan Channing, one of our nation’s most respected c-suite executives, uses a very straightforward methodology with the following benchmarks for “keeping the hospital happy”:⁹

• Build business
• Have rapid throughput
• Achieve high Hospital Consumer Assessment of Healthcare Providers and Systems (HCAPS) scores
• Have good communications
• Keep referral sources happy
• Simplify management issues
• Earn consistent and high quality scores
• Minimize hospital’s financial participation
• Support mission, vision, and values (specific to the Sinai Health System)

What does all this mean for EM? Where is the specialty going and in what direction? Will it emerge as a leader in effecting change? What are the metrics the specialty believes are critical to its success and legitimate for others to measure us by in this emerging new landscape? What new challenges should we be embracing? How can we help our hospital partners master transitions of care? The opportunities and timing are peaking for emergency medicine.

Mr. Holstein is a director at Zotec Partners in Bala Cynwyd, Pennsylvania.

Dr. Sama is President of Progressive Emergency Physicians Management, LLC, and Past President of ACEP.

References

1. Rappleye E. 8 steps to leading healthcare transformation. Becker’s Hospital Review. November 25, 2014.
2. American Medical Association. CPT 2014 Professional Edition. Atlanta, GA: American Medical Association; 2014.
3. Davis C. BTN’s 2014 Corporate Travel Index. Business Travel News. March 17, 2014
4. Diamond D. Health Care For $4: Are You Ready for Walmart To Be Your Doctor? Forbes. August 8, 2014.
5. Ellison A. 200 hospital benchmarks. Becker’s Hospital Review. October 1, 2014.
6. Eggbeer B, Bowers K. Health care’s new game changer: thinking like a health plan. Healthc Financ Manage. 2014; 68:52–59.
7. Mellin A, Funk C. The 6 lenses of population health management. Healthc Financ Manage. 2014; 68:62-6, 68.
8. ‘We need to show up with evidence’: Edwards Lifesciences CEO. Modern Healthcare. January 24, 2015.
9. Channing A. What a CEO expects from an EM group. Presented at: AAEM Scientific Assembly; February 11, 2013; Las Vegas, NV.