(contract management groups) can provide a valuable community
service by operating a better emergency department (ED), recruiting
better physicians and providing patient quality management
Robert Broida, M.D., an emergency physician and
consultant for ED
Quality Solutions Inc., Cleveland. "It's the board of
directors' responsibility to ensure that quality of care is upheld.
They hold the ball in their hands."
It comes down to hospitals
taking the initiative to manage their CMG relationships, says George
Molzen, M.D., immediate past president of the American College of
Emergency Physicians (ACEP). Before hiring a CMG, the board needs to
be specific about their expectations and include those expectations
in their contract. A CMG should add value to the hospital relative
to patient care, staffing and assistance in achieving a hospital
ED's goals and objectives.
If you have concerns, ask to speak to three to five hospitals
where that CMG has lost a contract. This may provide insight into
The following is a list of provisions recommended by the ACEP and
the American Academy of Emergency Physicians that should be included
in a CMG contract with a hospital and/or physician group:
- The provisional period should not exceed one year. Physicians
should be allowed due process.
- A defined mechanism should be included that regularly and
automatically provides all emergency physicians details of their
professional charges and collections.
- An additional mechanism is needed that regularly and
automatically provides all full partners with the total charges
and collections for the CMG, and the distribution of all income,
including all management and operational expenses such as
coding/billing/collection, professional liability insurance,
nonphysician employee salaries and physician administrative
- Physicians should be provided details of the CMG's governance
process, including the method of electing leaders and new
partners, appointing medical directors and administrators and
revising the board's bylaws.
- Physicians should not be required to agree to post-contractual
- The CMG should be wholly owned by practicing physicians.