Three Levels of Physician-Hospital Alignment

One of the most vital strategies in the current health care environment is physician-hospital alignment.

Many physicians perceive 'alignment' to be synonymous with employment, likely a result of the strategies of the 1990s, when it almost always meant physician employment. No longer is employment the only option, however. There are differences between what physicians and hospitals want out of their relationships, and more alignment structures are emerging to meet their goals.

Picture the myriad alignment structures along a continuum:

• A limited integration model describes a commitment in which the parties are tied together or joined by agreements or other arrangements that are relatively easy to unwind.
• A moderate integration structure is a more complex relationship, may involve financial risk by both parties and is more difficult to undo.
• A full integration model describes the most comprehensive form of alignment in which the physicians are compensated as employees of the hospital or health system or have a contractual relationship, typically one involving some exclusivity or noncompetition terms.