Considerations for Merging Medical Staffs in Multiple Hospital Health Systems
Thanks to recent changes in the Centers for Medicare & Medicaid Services (CMS) conditions of participation in Medicare, hospitals under a single governing board can now unify or merge their medical staffs. During a recent National Association Medical Staff Services (NAMSS) webinar, Todd Sagin, President of Sagin Healthcare Consulting, discussed key considerations for healthcare systems seeking to combine their medical staffs.
Here’s what you need to know if your healthcare system is considering merging or combining your medical staffs.
CMS Conditions for Medical Staff Unification
In July 2014, CMS made new regulations effective, allowing the unification of medical staffs. Section 482.22(b) was revised in the final rule, adding a provision which permits the medical staff of a hospital which is part of a hospital system consisting of multiple, separately certified hospitals to participate in a unified, integrated medical staff which the system utilizes for two or more of its member hospitals, in accordance with State law. However, there are very specific requirements:
- The system governing body must conduct a review of all applicable State and local laws, including regulations, and make a determination that use of a unified medical staff does not conflict with those laws.
- The system governing body must elect to use a unified, integrated medical staff.
- A majority of the medical staff at each hospital must vote to accept the unified staff structure for its hospital.
Top Reasons to Consider Unification
There are several reasons why a healthcare system might consider unifying their medical staff. It can provide greater user friendliness for physicians, according to Sagin. This means there is only one application, one reappointment to track, communications from one source, and fewer meetings.
Efficiency is the greatest benefit of this process. Unification means consolidation of medical staff, effective use of physician leadership bench strength, and greater standardization across your health system. This allows your organization to disseminate best practices much more quickly, Sagin says.
Additionally, a unified medical staff reduces the amount of work for your health system’s board. You don’t have to process multiple applications from multiple physicians while also reducing your potential for liability. As Sagin noted, there are potential issues when one hospital that’s part of a health system rejects a physician’s application but another from within the same system approves the same individual. Unifying medical staffs promotes consistency and supports compliance in these instances.
Why Unification May Not Be for Everyone
While there are certainly many benefits to having a unified medical staff, there are a few downsides as well. Medical staff consolidation means there is less focus on local hospital campus issues. By its nature, there is less individuality so your system should consider how it can continue to address local hospital issues if unification is still part of your plan.
Additionally, unification translates to fewer physicians engaged in the development of leadership skills. While this may be a benefit because of the scarcity of physician leaders, succession planning and leadership development are key for long-term success.
Finally, medical staff consolidation brings a set of communication challenges. Your healthcare organization should consider how to communicate effectively across a large organization that now encompasses an even larger geography and multiple institutions, Sagin explains. Effective communication is key to a successful unification.
While there are important factors to consider both from a compliance and implementation perspective, combining medical staffs in multiple hospital systems can bring many benefits. It can improve the experience and make physicians happier with your process, and who wouldn’t want that?
What are your thoughts? Is unification of medical staffs the future of healthcare? We’d love to hear from you in the comments section below.