The Brooklyn Hospital Center

IHC has recently been engaged by The Brooklyn Hospital Center (TBHC) to restructure its relationship with its employed physicians.  A large teaching hospital and affiliate in the New York-Presbyterian Healthcare System, TBHC is currently operating under bankruptcy.  In addition to other losses, the employed physicians drive about $3MM in annual losses.  Therefore, IHC’s project aims to:  (1) improve the economic performance of TBHC’s employed physicians and (2) collaborate with the physicians to achieve that goal.  Short-term, the goal is to reduce losses.  In the long-term, we aim to set the stage for development of an organized and empowered faculty practice plan. Given the history of distrust between physicians and administration, IHC will have to play the role of “objective intermediary” to ensure successful implementation of the strategic plans.

In terms of the project structure, IHC’s initial efforts will focus on staunching the physician losses by providing appropriate incentives to improve productivity and revenue generation.  First, IHC will assess physician performance (by Department and Division), including compensation and productivity.  Working with the Chairs, we will then set performance targets and design the incentives needed to achieve those goals   Collaboration with the Chairs will yield both short-term incentives and a new compensation model that dovetails with TBHC’s overall economic performance improvement strategy.  Essential to achieving this goal will be securing commitment of MDs to strategy implementation.

This strategy will create a clear path to solid economic performance.  The short-term components will include:

• Redesign of the compensation model to provide appropriate incentives to both physicians and TBHC

• Strengthening of “Professional Staff Organization” and its interactions with TBHC

• Improved revenue interface between TBHC and the physician practices

• Examination of the costs/benefits of centralization of billing and collections and, if so chosen, development of the appropriate outsourcing vendor RFP

With these components in place, we will move toward practice plan development.  Success will be defined both economically and organizationally, which means strengthened physician governance and standardization of process and staff function across the Departments.  In addition, succession planning for MDs at TBHC is a crucial long-term goal and should be developed in a joint physician-hospital effort.