Cogent Makes a Case for Hospitalists
BRENTWOOD, TN – With all that’s going on in the arena of healthcare reform, one wonders whether hospitals have the time to properly manage their doctors. That’s the thinking of Cogent Healthcare, a 13-year-old hospitalist provider that has seen business skyrocket recently as beleaguered hospitals see the value in outsourcing their physician needs. Company officials say their partnerships with hospitals have been found to improve clinical outcomes, reduce wasteful spending and boost employee morale.
“It’s essentially putting doctors where the sickest patients are and having them stay there,” said Ron Greeno, chief medical officer and founder of the Brentwood, Tenn.-based company, that estimated there are more than 31,000 hospitalists nationwide. “We are the primary care physicians within the hospital.”
According to Greeno and Gene Fleming, Cogent’s CEO, close to 90 percent of the nation’s larger hospitals – those with 200 or more beds – have some hospitalists on hand, whether it’s for inpatient needs or more specific areas. And with specialists finding they can make more money in offi ce-based practices, hospitals are seeing more of a demand for physicians who can be on-site at all times.
“We help connect the dots so that at the end of the day there’s a good hand-off from the inpatient doctor to the outpatient doctor,” said Fleming. Hospitalist programs are proving popular with hospitals because physicians are focused on the delivery of quality healthcare, and not balancing their time between the hospital and their practice. At a time when healthcare reform efforts are focused on quality measures, “this is all about performance,” said Greeno.
“This isn’t a staffing issue – it’s a care management issue,” he added. Cogent’s work with hospitals generally follows one of two routes: Hospital administrators either contract with Cogent to provide physicians or manage those already in place, making them Cogent employees. Cogent also puts in place a medical director and business manager and works with administrators – the CMO, CEO or even the CFO – to establish performance measures.
“There is an under appreciation of how hard this is – that’s why programs fail.” said Greeno. “You have to find the right doctors and train them to perform under a new model of care. You have doctors out there who know how to practice medicine; they just don’t know how to be hospitalists.”
In recent months, Cogent has been contracted to provide hospitalist services for North Mississippi Medical Center, a 650-bed regional health center in Tupelo, Miss.; and Allegiance Health, a 411-bed health system in Jackson, Mich. Allegiance launched its own hospitalist practice in 2006 with four practitioners, and has seen that unit grow to 14 physicians and two nurse practitioners. The latest trend, Cogent officials say, is in intensive care and other high-acuity areas of the hospital.
“Cogent physicians are well trained and well-led, and their impact as hospitalists and intensivists significantly reduced the length of stay and resource use for our patients while improving outcomes,” said Andrew Robertson, MD, vice president of medical affairs of St. Bernardine Medical Center in San Bernardino, Calif., which piloted the company’s intensivist program earlier last year.
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