Medical group governance for better organisational integration

Today, three of four US physicians are employed by hospitals, health systems or corporations. Forward-thinking healthcare leaders are looking for ways to leverage the intellectual capital of their employed and affiliated physicians and tighten physician–hospital integration as a means to improve care management and coordination, improve access and quality and reduce costs. Structured medical group governance is one such approach taken by healthcare leaders to enable meaningful and intentional physician–hospital joint decision making and better integration. Governance enables providers to unify and speak with one collective voice, influence the business side of clinical matters, build a unified brand and culture within the organisation and set policy or standards needed to be adopted at scale, to name just a few. Since 2019, Providence Health, a national not-for-profit Catholic Health System providing services across seven states with nearly 9,000 employed or affiliated physicians, has developed a multi-tiered medical group governance structure to coalesce on strategic direction and the major decisions that influence the clinical practice. This paper describes Providence Health’s journey in designing and maturing its medical group governance structure. In this case study, the authors describe the why, the what and the how of medical group governance and provide lessons learned and specific examples of the impact Providence Medical Group boards have had on clinician integration, engagement and alignment across the system.